Adverse Childhood Experiences (ACEs) in Pregnancy: Screening, Identification and Referral

Abstract

Adverse childhood experiences (ACEs) are traumatic events that occur between birth and eighteen years of age (Radcliffe, Crouch, & Strompolis, 2018). The ACEs questionnaire consists of ten “yes” or “no” questions that address abuse, neglect, parental conflict, parental substance abuse, and parental mental illness (Hughes et al., 2017). Each “yes” answer is worth one point. A score ≥ four ACEs is associated with increased risk for maladaptive behaviors, poor physical health, and poor mental health. This quality improvement (QI) project developed a successful plan of screening, identification, and referral for ACEs with women receiving care at a community health department. Results included 311 women were screened for ACEs. Forty had a score of ≥ four and were offered referral information. This QI project helped to start a conversation about ACEs in a rural community affected by substance abuse, mental health, and chronic health conditions. Further work should include screening for ACEs in other settings, providing trauma-informed care, and focus on reducing the impact of ACEs.