Pregnant Women's Perspectives on Screening for Adverse Childhood Experiences and Resilience During Prenatal Care

Clinical Impact Statement This study advances the idea that pregnant women value screening for adverse childhood experiences (ACEs) and resilience for themselves and their partners during standard prenatal care. Additionally, it highlights opportunities for women's health professionals to educate parents about the potential impact of ACEs on health and foster resilience during this important time. Objective: To examine the acceptability of routine screening for adverse childhood experiences (ACEs) and resilience during prenatal care. Method: This study examined pregnant women's perspectives (N = 119) on ACEs and resilience screening during prenatal care in two medical centers via postscreening telephone surveys. Chi-square tests and Fisher's Exact Tests examined whether responses varied with ACEs (0 [62.2%], 1-2 [21.0%], 3+ [16.8%]) or resilience (high [64.7%] vs. low [35.3%]). Results: The sample (N = 119) was 36.1% non-Hispanic White, 26.1% Hispanic, 8.4% Black, 23.5% Asian/Pacific Islander, and 5.9% Other, with a median age of 31 (IQR: 28-34) and average neighborhood median household income of $100,734 (SD = $37,079). Most women thought prenatal care should include conversations about ACEs (82.2%) and resilience (94.0%) and very strongly believed that good coping skills can help reduce the harmful effects of childhood stress (79.0%). Nearly half (41.2%) used >= 1 mental health resource from the resource handout provided at screening. Some women thought conversations could be improved if they took place with a mental health professional (37.3%), with more provider empathy (40.7%), more education about ACEs and health (55.1%), and if the screening included additional stressors (53.4%). Notably, most women (73.5%) would like their partner to also receive the screening. Women with more ACEs were more likely to want a longer conversation, and those with low versus high resilience were more likely to prefer that a mental health professional conduct the screening. Conclusions: Results indicate that women value ACEs screening during prenatal care and provide actionable recommendations to improve future screenings and discussions.

Automated summary

This study highlights the importance of screening for adverse childhood experiences (ACEs) and resilience during prenatal care, as perceived by pregnant women. The findings provide recommendations for improving future screenings and discussions, including involving mental health professionals and providing more education about ACEs and health.