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Adverse childhood experiences

Adverse childhood experiences (ACEs) refer to traumatic events that happen during childhood, such as abuse, neglect, or problems at home (for example parental substance abuse, domestic violence, or mental illness).

These experiences can have long-lasting negative effects on physical, emotional, and psychological well-being, which can also affect preconception health and pregnancy outcomes.

Research shows that ACEs are linked to various health problems in women during pregnancy, such as depression, anxiety, gestational diabetes, and poor birth outcomes.

However, screening for ACEs is not widely done in antenatal care settings.

Pregnancy often makes people think more about parenting, which can bring up unresolved past trauma, especially for those who experienced childhood abuse or neglect.

During pregnancy, symptoms of anxiety or post-traumatic stress disorder (PTSD) may return or appear for the first time.

Pregnancy is a major emotional and psychological change, and for those with a history of ACEs, this time can be particularly difficult.

ACEs can have serious effects on preconception health, affecting both mental and physical well-being, and increasing the risk of poor pregnancy outcomes.

By addressing the long-term impact of childhood trauma through trauma-informed care, mental health support, and encouraging healthier lifestyle choices, individuals with a history of ACEs can improve their preconception health and have a better chance of a healthy pregnancy and family life.

Messages for professionals to share:

  • encourage women and pregnant people to contact their doctor or midwife as soon as they find out they are pregnant
  • with the right support, healthcare providers can help address the effects of childhood trauma, offering mental health care, trauma-informed services, and parenting education
  • doing this can create a healthier environment for both parent and child - support during pregnancy through mental health counselling, support groups, and parenting programmes can promote emotional well-being, build resilience, and create a nurturing environment

It’s important to reassure people who have experienced ACEs that their past does not define their or their baby’s future.

Pregnancy can bring a sense of hope and motivation, offering an opportunity to reflect on their own childhood, make positive changes, and address past trauma for the first time.

Potential parents should be encouraged to seek support openly and honestly during this time.

Early intervention and support can help create a healthier emotional environment for both parent and child.

Referral pathways for specialised services: