Would pregnant women participate in surveys from their doctors asking them about whether they had experienced trauma in their childhood? In surveying moms-to-be at two Northern California Kaiser sites, clinicians discovered that the women were receptive to filling out an adverse childhood experiences (ACE) survey, according to a study that was published earlier this year in the Journal of Women’s Health.

In fact, researchers found out that the vast majority of pregnant women — 91 percent of the 375 women— were “very or somewhat comfortable,” filling out the ACE survey. Even more, 93 percent, said that they were comfortable talking about the results with their doctors. The women were surveyed from March through June 2016 at Kaiser Permanente clinics in Antioch and Richmond, CA.

ACE refers to the groundbreaking CDC/Kaiser Permanente Adverse Childhood Experiences Study that tied 10 types of childhood trauma, including living with an alcoholic family member or experiencing verbal abuse from a parent, to a host of health consequences. (Got Your ACE Score?)

The higher the number of ACEs that people have, researchers learned, markedly increases their risk for poor health outcomes, as well as social and economic consequences. Having four ACEs, for example, nearly doubles a person’s risk for heart disease and cancer, raises the risk of attempted suicides by 1200 percent and alcoholism by 700 percent.

The study, first published in 1998, emerged with a growing body of ACEs science that includes: how trauma affects the brain; how toxic stress has epigenetic effects from one generation to the next; how toxic stress from trauma results in short- and long-term health consequences; and how appropriate supports can build resilience and heal the harmful effects of toxic stress from ACEs. (ACEs Science 101.)

What really stood out for Dr. Carey Watson, one of the authors of the study, was the number of patients who felt strongly that their doctors should ask them about their ACEs. Around 85 percent of the participants “strongly or somewhat strongly agreed” that doctors should ask their patients about ACEs.

“it was really, really eye opening to me,” she said. “I was used to screening patients for ACEs, but I wasn’t sure how they would feel about it later.”

Researchers also screened patients for how resilient they are in coping with adversity using the Connor Davidson resilience screening scale. “We were interested in framing the conversation with patients in a way that might be more empowering or positive,” Watson noted. (Interpreting how patients’ resilience and ACE scores translate to health outcomes is the focus of an upcoming study by Watson and her peers.)

But Watson and her colleagues were also well aware that beyond their patients, they really needed to understand how their fellow physicians would feel about screening their prenatal patients about their ACEs. Would they find it acceptable, they wondered? Watson said that she was well aware that many of her colleagues were reticent about asking their patients about childhood trauma, wondering if a conversation would “open up a can of worms,” as Watson put it. That worry, said Watson, was perfectly understandable.

“This is a very foreign concept and uncomfortable for providers. It was not anything that any of my colleagues learned about in medical school,” Watson said.

A pre-pilot survey of clinicians showed they had “moderate” concerns about ACEs screening. After the pilot, which included training in trauma-informed care – how to talk in a sensitive manner to patients — their confidence and knowledge around ACEs screening increased.

Read the full story at: https://bit.ly/2J7McOx