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Addressing Adverse Childhood and Adult Experiences During Prenatal Care

Sara Johnson1, Nadine A Kasparian, Arlene S Cullum

  • 1La Clinica de La Raza, Oakland, the California Maternal Quality Care Collaborative and the Departments of Pediatrics and Obstetrics and Gynecology, School of Medicine, Stanford University, Palo Alto, and the Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California; and the Department of Pediatrics, University of Cincinnati College of Medicine, Center for Heart Disease and Mental Health, Heart Institute, and Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Obstetrics and Gynecology
|May 4, 2023
PubMed

Insights

Obstetric clinicians can improve perinatal health by inquiring about and responding to pregnant patients' past adversity and trauma using trauma-informed care. This approach supports healing and creates individualized care plans for better health outcomes.

Area of Science:

  • Perinatal Health
  • Trauma-Informed Care
  • Obstetrics

Background:

  • Adverse childhood and adult experiences significantly impact lifelong and intergenerational health outcomes.
  • The perinatal period presents a crucial window for obstetric clinicians to intervene and enhance patient well-being.
  • Existing care models may not adequately address the pervasive effects of trauma and adversity in pregnant populations.

Purpose of the Study:

  • To provide recommendations for obstetric clinicians on inquiring about and responding to pregnant patients' adversity and trauma during prenatal care.
  • To advocate for the adoption of trauma-informed care as a universal intervention in perinatal settings.
  • To guide the integration of support systems and individualized care plans for patients with adverse experiences.

Main Methods:

  • Synthesizing stakeholder input, expert opinion, and current evidence.
  • Developing recommendations for clinical practice regarding trauma and adversity inquiry.
  • Outlining preparatory steps for implementing trauma-informed care in prenatal settings.

Main Results:

  • Trauma-informed care can proactively address adversity and trauma, fostering healing even without explicit disclosure.
  • Inquiry into past and present adversity and trauma facilitates tailored support and individualized care planning.
  • Key preparatory steps include staff education, addressing racism and disparities, and building patient trust.

Conclusions:

  • Implementing trauma-informed care in prenatal settings is essential for improving perinatal health outcomes.
  • Gradual integration of inquiry methods (open-ended questions, surveys) can be effectively utilized.
  • Enhanced clinical training, research, and interdisciplinary collaboration are vital for advancing trauma-informed perinatal care.

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