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Identifying adverse childhood experiences in maternity services

02 February 2021
Volume 29 · Issue 2

Abstract

Background

Maternity services have a unique opportunity to support women and families to build resilience and mitigate against the harmful impact of parental exposure to adverse childhood experiences (ACEs) but, most importantly, to prevent exposure to ACEs in future generations.

Aim

To identify ACEs in families who use maternity services in order to improve the professional response to risk, build parental resilience and strengthen parenting capacity.

Methods

A quality improvement project piloted an ACEs screening tool with 44 women and their partners when booking for maternity services. Implementation was supported by the development of a range of bespoke tools. Evaluation took place through quantitative data analysis and qualitative feedback from professionals and parents.

Findings

The use of the ACEs screening tool successfully identified ACEs which would otherwise not have been known using the previous antenatal booking questions. The bespoke tool kit was well-received by women, their partners and professionals. Identification and discussion of ACEs enabled appropriate support to be offered.

Conclusion

Identifying ACEs in maternity services and offering additional support requires further work before wider implementation. These interventions have the potential to reduce risk, build resilience and strengthen parenting capacity which could protect infants from experiencing a cycle of adversity.

The aim of the project was to introduce into maternity services a screening tool for women and their partners at booking, in order to identify adverse childhood exper iences (ACEs) and improve professional response to risk, build parental resilience and strengthen parenting capacity.

Analysis of serious case reviews (SCR) has shown that the largest proportion of non-accidental incidents involving significant harm, maltreatment or death, occur in the youngest children (Sidebotham et al, 2016; Brandon et al, 2020). In the most recent triennial review of a total of 368 SCRs from 2014–2017, 42% (154) involved children aged under one year (Brandon et al, 2020). Serious and sometimes fatal maltreatment may take place within the family, with children living at home, or with relatives at the time of the injury (Brandon et al, 2020).

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