Clinicians' Experiences and Recommendations for Implementing Trauma-Informed Care in Perinatal Settings

Area of Science:

• Perinatal Health
• Implementation Science
• Trauma-Informed Care

Background:

• Trauma-informed care (TIC) is vital for perinatal health, yet its integration is limited despite high rates of childhood adversity.
• Understanding implementation determinants of TIC in perinatal settings is underexplored.

Purpose of the Study:

• To explore perinatal clinicians' experiences with implementation determinants influencing trauma-informed care (TIC) integration.
• To identify system- and practice-level factors affecting TIC in perinatal services.

Main Methods:

• Semi-structured interviews with 23 perinatal clinicians in an urban academic health system.
• Analysis using the Consolidated Framework for Implementation Research (CFIR), combining inductive and deductive approaches.

Main Results:

• Systemic inflexibility, lack of supportive structures, standardized processes, and resources are key challenges to TIC implementation.
• Clinicians identified best practices and opportunities for improving TIC delivery.
• Facilitators include enhanced institutional support and interprofessional collaboration.

Conclusions:

• Addressing systemic barriers is essential for effective TIC integration in perinatal care.
• Leveraging facilitators can improve clinical practice and organizational culture for better outcomes.
• Enhanced TIC can positively impact pregnant and postpartum individuals.