Exploring women's perspectives on prenatal screening for adverse childhood experiences

Objective: To learn more about women's views on screening for adverse childhood experiences (ACEs) during healthcare visits in pregnancy.

Design: Mixed methods with an online survey.

Sample: A convenience sample of 154 women with a history of one or more pregnancies was recruited through public health department social media pages in one predominantly rural region of a Midwest state.

Measurements: Quantitative measures included demographic variables, ACE scores, and preferences regarding screening format, strategies, and resources. Additional perspectives were captured through open-ended questions.

Results: Women's mean ACE score was 2.56 (SD = 2.37) with 68% reporting 0-3 ACEs and 32% reporting four or more. Routine screening for ACEs during prenatal care was supported by 67.5% of women with 9.1% indicating sometimes, 20.8% unsure, and 2.6% against. Strong preference was indicated for screening by one's physician or midwife (80.3%), in an exam room (83.1%), using an independently completed questionnaire (64.2%). Preferred approaches for screening and post-screening interventions also were identified with qualitative themes providing additional insights.

Conclusions: Findings inform strategies for efficiently and sensitively screening for ACEs during pregnancy, highlight the importance of using a trauma-informed approach, and provide direction for educational and interventional resource development.