Exploring trauma-informed prenatal care preferences through diverse pregnant voices.

BACKGROUND

There are no existing standards of care for integrating trauma-informed care into prenatal care in a patient-centered manner. This study aims to explore preferences of pregnant people regarding prenatal care, prenatal providers, resources, and trauma inquiry and response.

METHODS

This study utilized a qualitative descriptive design as part of a longitudinal randomized controlled pilot trial. It was conducted at a university-affiliated federally qualified health center and multi-specialty clinic in a large metropolitan area among a purposive sample of 27 racially/ethnically diverse pregnant individuals. Eligible participants aged ≥ 18 between 10 and 24 weeks gestation were identified via medical charts and recruited in person and by email. Interview-administered structured interviews were provided at the post-intervention assessment. Qualitative data collection extended from June 2023 through April 2024. We performed inductive analysis to generate codes and identify emergent themes derived from participant responses. Participant preferences for prenatal care were interpreted through the lens of the six trauma-informed care principles.

RESULTS

Participants had an average age of (M = 28, SD = 4.5; range = 19-38) years old. Of the 27 participants interviewed, 21 self-identified as Black (77.8%) and 5 as Hispanic (18.5%). Three themes identified optimal prenatal care preferences, including: (1) Agency and Choice; (2) Emphasis on Maternal and Child health and Wellbeing; and (3) Universal and Personalized Provision of Information and Resources. Participants wanted their providers to be Familiar and Experienced; Personally Engaging; and Emotionally Safe and Supportive. Three additional themes focused on patient preferences for addressing trauma during prenatal visits, including: (1) Value of Addressing Trauma; (2) Approaches to Asking about Trauma; and (3) Sensitive and Empathic Inquiry and Response.

CONCLUSIONS

Patient preferences identified by this study underscore the need for prenatal care to address the psychological health needs of pregnant patients to deliver high quality, comprehensive prenatal care that is trauma-informed and culturally-responsive.

TRIAL REGISTRATION

This study was registered at ClinicalTrials.gov ID: NCT05718479 on 08-02-2023.