ARE WE TRAUMA-INFORMED? EVALUATING THE HEALTHCARE EXPERIENCE OF PREGNANT AND PARENTING ADOLESCENTS IN THE CONTEXT OF CHILDHOOD TRAUMA.

Objectives Childhood trauma is a risk factor for adolescent pregnancy and these adolescents experience worse pregnancy outcomes. Our objective was to understand the pregnancy care experiences and preferences of pregnant and parenting adolescents who are trauma survivors. Methods Adolescent female parents aged 12-22, receiving care in a hospital-based young families program, were recruited to participate in a mixed-methods study consisting of the Adverse Childhood Experiences (ACE) questionnaire, a study-specific questionnaire and a one-on-one interview. Questionnaire data was analyzed using descriptive statistics. Interviews were transcribed and analyzed following methods of thematic analysis. Research Ethics Board Approval was obtained. Results 14 questionnaires and 3 interviews have been completed. The average age of participants was 17.9, with 71.4% primips. The mean ACE score was 5 out of 10, with 64.3%, 57.1% and 50.0% having experienced emotional, physical and sexual abuse as a child, respectively. 71.4% of participants reported being triggered during pregnancy or postpartum. Trauma memories were elicited during vaginal exams in clinic (42.9%) and in hospital (50%), abdominal exams (35.7%), measurement of vital signs (28.6%) and labour (7.1%). 35.7% felt that providers delivering their baby knew how to help them cope with trauma memories. Emerging themes from the interviews include: control and choice, avoiding retelling of story, safety, and peer support. Conclusions There is a high prevalence of childhood trauma amongst our parenting adolescents. A majority of these girls experienced trauma memories during pregnancy and postpartum medical interactions. Priorities to improve care will be discussed.