Citation

Millar HC, Lorber S, Vandermorris A, Thompson G, Thompson M, Allen L, Aggarwal A, Spitzer RF. J. Pediatr. Adolesc. Gynecol. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, North American Society for Pediatric and Adolescent Gynecology, Publisher Elsevier Publishing)

DOI

10.1016/j.jpag.2021.01.006

PMID

unavailable

Abstract

STUDY OBJECTIVE: To understand the pregnancy and childbirth experiences and preferences of adolescent mothers with a history of childhood trauma in order to develop trauma-informed care practice recommendations for this unique group DESIGN: mixed methods convergent parallel design involving completion of the Adverse Childhood Experiences (ACE) questionnaire, a survey of care experiences and preferences during pregnancy and delivery, and a one-on-one interview SETTING: hospital-based medical home program for pregnant and parenting adolescents PARTICIPANTS: adolescent mothers aged 12-22, receiving care between June 2018 and June 2019 RESULTS: Twenty-nine adolescent mothers completed the questionnaire, out of a potential 38 in the program (76.3% participation). Five went on to complete an interview. The average age was 17.9 (SD 1.8yrs). The mean ACE score was 5.1 out of 10, indicating childhood exposure to an average of five different types of potential trauma. Nineteen participants (65.5%) reported being triggered during pregnancy or postpartum. Trauma memories were elicited during vaginal exams in clinic (27.6%) and in hospital (27.6%), abdominal exams (13.8%), measurement of vital signs (17.2%) and labour (17.2%). Ten participants (34.5%) felt that the providers delivering their baby knew how to help them cope with trauma memories. Themes that emerged included: acknowledgment of trauma by provider, avoiding re-telling of story, building a relationship with provider, choice and control in care, and providing coping strategies.

CONCLUSION: A majority of adolescent mothers in our sample experienced trauma memories during pregnancy and postpartum medical interactions. Priorities for trauma-informed care in this population are described.

Language: en

Keywords

Child maltreatment; qualitative research; communication; adverse childhood experiences; post-traumatic; obstetrics; patient preference; perinatal care; pregnancy in adolescence; stress disorders; trauma-informed care