Addressing Adverse Childhood and Adult Experiences During Prenatal Care

Abstract

Screening for adverse childhood and adult experiences in prenatal care allows clinicians to address past and present adversity and trauma, with a goal of improving perinatal outcomes.

An Integrative Review of Adverse Childhood Experiences and Reproductive Traumas of Infertility and Pregnancy Loss

“…An appropriate time to screen may be during a visit when trust has already been established and the initial reason for entry to care has been addressed. 62 Midwives and other advanced providers are wellpositioned to assess for ACEs, as they are often the first to see patients in provider offices, hospitals, and rural areas and may be the primary care providers. 63 Furthermore, women with a history of ACEs were found to have more anxiety, depression, and posttraumatic stress as well as increased substance use, including tobacco and alcohol, during the perinatal period.…”

“…Screening should also inquire about strengths and resilience which can be incorporated into the patient's care plan to maintain their emotional safety. 62 Mishra et al 64 reported that patients have a positive attitude to ACE screening if health care providers showed empathy and caring behaviors and provided appropriate care and referral resources to address their needs after an ACE evaluation. Collaborating and coordinating the patient's care across settings and specialties, using a whole-person approach, increases opportunities for successful TIC.…”

“…Collaborating and coordinating the patient's care across settings and specialties, using a whole-person approach, increases opportunities for successful TIC. 62…”