Slide 1 — Background

Humanizing the Cesarean Experience: Standardizing Trauma-Informed, Patient-Centered Care in the Obstetric Operating Room

Dr Darragh O'Reilly, Dr Naima Kotadia, Dr Kathryn Clark, Dr Katherine Seligman

Background

Cesarean delivery (CD): Can be experienced as distressing¹

Prevalence: ~33% report birth as traumatic; higher with unplanned CD.²

Contributors: Loss of autonomy, limited communication, separation from support persons.

Gap: Trauma-informed, patient-centered care recognized—but inconsistent in CD practice.

Aim: To promote trauma-informed, patient-centered practices in the OB OR.

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Slide 2 — Study Design and Methods

Setting: MDT at tertiary center (>7000 deliveries/year; CD rate 42%)

Design: Quality improvement implementation study to standardize trauma-informed, patient-centered cesarean delivery practices.

Focus areas: Shared patient–provider values, staff education.

Approach: Integrate patient-centered options into existing workflows without introducing new interventions.

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Slide 3 — Results

Standardized options for elective and urgent CD (when appropriate):

• Support person present during neuraxial anesthesia placement
• Patient selected music in the OR
• Temporary draping during catheter insertion and prep
• Support person present at delivery (if under GA)
• Immediate skin-to-skin contact
• Live video of neonatal care if separation required
• Option for additional support (doula, midwife, extra support person)

Patient feedback themes:

• Greater feelings of involvement in their own care
• Increased sense of respect and dignity during the procedure
• Enhanced emotional support during what can be a vulnerable experience

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Slide 4 — Discussion and Conclusion

Standardization: Embedding patient-centered practices into protocols supports trauma-informed cesarean care.

Scalability: Approach may be generalizable to other centers.

Next steps: Develop a preoperative preference tool to enhance engagement and individualize care plans.