Department of Paediatrics, Division of Endocrinology, Section of Gynecology, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada.
Department of Paediatrics, Division of Adolescent Medicine, Hospital for Sick Children, Toronto, Ontario, Canada; Factor-Inwentash Faculty of Social Work, University of Toronto, Ontario, Canada.
J Pediatr Adolesc Gynecol. 2021 Aug;34(4):538-545. doi: 10.1016/j.jpag.2021.01.006. Epub 2021 Jan 31.
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.
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.
hHospital-based medical home program for pregnant and parenting adolescents.
Adolescent and young adult mothers aged 12-22 years, receiving care between June 2018 and June 2019.
A total of 29 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 years (standard deviation 1.8 years). The mean ACE score was 5.1 out of 10, indicating childhood exposure to an average of 5 different types of potential trauma. A total of 19 participants (65.5%) reported being triggered during pregnancy or postpartum. Trauma memories were elicited during vaginal examinations in the clinic (27.6%) and in the hospital (27.6%), abdominal examinations (13.8%), measurement of vital signs (17.2%), and labor (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 the following: acknowledgment of trauma by provider, avoiding re-telling of story, building a relationship with provider, choice and control in care, and providing coping strategies.
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.
了解有儿童期创伤史的青少年母亲的妊娠和分娩经历和偏好，以便为这一独特群体制定创伤知情护理实践建议。
混合方法(convergent parallel design)，包括完成不良童年经历（ACE）问卷、妊娠和分娩期间护理经历和偏好的调查以及一对一访谈。
医院为孕妇和哺乳期青少年提供的医疗之家项目。
12-22 岁接受 2018 年 6 月至 2019 年 6 月期间护理的青少年和年轻母亲。
共有 29 名青少年母亲完成了问卷，该项目中共有 38 名潜在参与者（参与率为 76.3%）。其中 5 人继续接受了采访。平均年龄为 17.9 岁（标准差为 1.8 岁）。平均 ACE 得分为 5.1 分（满分 10 分），表明儿童期经历了平均 5 种不同类型的潜在创伤。共有 19 名参与者（65.5%）报告在怀孕期间或产后受到触发。在诊所（27.6%）和医院（27.6%）进行阴道检查、腹部检查（13.8%）、生命体征测量（17.2%）和分娩（17.2%）时，会引出创伤记忆。10 名参与者（34.5%）认为分娩婴儿的提供者知道如何帮助他们应对创伤记忆。出现的主题包括以下几点：提供者对创伤的承认、避免重述故事、与提供者建立关系、护理中的选择和控制以及提供应对策略。
我们样本中的大多数青少年母亲在妊娠和产后的医疗互动中都经历了创伤记忆。描述了该人群中创伤知情护理的优先事项。
