Perinatal interventions for mothers and fathers who are survivors of childhood sexual abuse

Abstract

Childhood sexual abuse (CSA) is a worldwide problem with severe long-term consequences. A history of CSA can impact the childbearing experience of mothers and fathers; affecting their mental health, parenting skills and compromising infant development. Nonetheless, the perinatal period offers huge opportunity for intervention and hope. This literature review collates evidence for perinatal psychosocial interventions targeting both mothers and fathers who are survivors of CSA. Publications dating from 1970 to June 2016 were searched using Medline, Maternity and Infant Health, PsychINFO, PsychArticles, PubMed and the International Bibliography of the Social Sciences (IBSS). There were no perinatal interventions that considered the needs of survivor fathers. Sixteen publications on 9 psychosocial perinatal interventions for CSA survivors were identified. However, no sub-analyses specific to CSA survivors were reported. Trauma-specific perinatal interventions drew from a range of theoretical models and varied widely in format. Generally interventions were associated with improvements in maternal mental health, parenting competence, infant attachment security and positive public health outcomes. They were safe and feasible to implement, acceptable to parents and therapist, and therapists were able to implement protocols with adequate fidelity. Yet current data is hampered by small sample size, inconsistent reporting of CSA rates and outcome measures, scarcity of observational data and longer-term follow-up. Intervention modifications are proposed for CSA survivors in view of their unique childbearing experiences.

Development of a prenatal program for adults with personal histories of childhood abuse or neglect: a Delphi consensus consultation study

“…First, we identified very few prenatal interventions specifically designed for expectant women and men who have personal histories of abuse or neglect, despite the long-term and intergenerational consequences associated with these adverse childhood experiences. 39 Second, our results confirm that health care providers and community organizations consider such an intervention important and a valuable addition to the services they already offer to victims of abuse or expectant parents. Third, the mentalization framework should be considered when developing such a program, with actions aimed at supporting participants' mentalization of their experience of parenthood and mentalization of their adverse childhood experiences.…”

“…52 Several prenatal programs have been designed for at-risk parents, and many have been shown to lead to significant improvement in parental functioning and to positive outcomes for children. 39,[52][53][54] However, to the best of our knowledge, few interventions specifically address the unique needs of parents with personal histories of trauma or use a theory of trauma as conceptual framework. Even parenting interventions aimed at preventing childhood maltreatment and trauma are rarely informed by trauma theories.…”

“…However, they are not specifically designed to address the particular challenges associated with the experience of childhood trauma or do not evaluate their effects in parents with histories of abuse or neglect. 39 Conceptualizing specific interventions for this population may be important, as the way adults with histories of abuse or neglect view their experiences plays a distinctive role in their adaptation to parenthood and in the attachment relationship they develop with their child. 8,22 A recent literature review confirmed that there are currently very few perinatal interventions for parents with histories of trauma and that no intervention was evaluated with fathers.…”

“…8,22 A recent literature review confirmed that there are currently very few perinatal interventions for parents with histories of trauma and that no intervention was evaluated with fathers. 39 Many of the programs listed above are designed to intervene primarily during the postnatal period. Only two programs specifically designed for adults with histories of trauma are delivered primarily during pregnancy: Survivor Moms Companion, a self-help manual, 40 and the Perinatal Child-Parent Psychotherapy, 41 which involves one-on-one psychotherapy.…”

Prenatal Attachment, Parental Confidence, and Mental Health in Expecting Parents: The Role of Childhood Trauma

“…histories of childhood maltreatment, but a recent literature review confirmed that there is currently no perinatal intervention that considered the needs of men with histories of childhood maltreatment. 46 This is particularly surprising knowing that childhood maltreatment affects both men and women, that men play a crucial and distinctive role in child development, and that prevention of family violence requires programs reaching both women and men. 47 Contrary to our expectations, there was no direct association between prenatal attachment and childhood maltreatment.…”