The authors report no conflict of interest or relevant financial relationships.
Childhood Maltreatment History, Posttraumatic Relational Sequelae, and Prenatal Care Utilization
Article first published online: 17 JUN 2013
© 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Volume 42, Issue 4, pages 404–415, July 2013
How to Cite
Bell, S. A. and Seng, J. (2013), Childhood Maltreatment History, Posttraumatic Relational Sequelae, and Prenatal Care Utilization. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 42: 404–415. doi: 10.1111/1552-6909.12223
- Issue published online: 16 JUL 2013
- Article first published online: 17 JUN 2013
- Manuscript Accepted: APR 2013
- National Institutes of Health (NIH)
- National Institute for Nursing Research. Grant Number: NR008767
- NIH pre-doctoral training. Grant Number: 5T32NR007073-20
- posttraumatic stress disorder;
- women's mental health;
- prenatal care;
- childhood maltreatment
To test the hypothesis that childhood maltreatment history would be associated with inadequate prenatal care utilization.
A post-hoc analysis of a prospective cohort study of the effects of post traumatic stress disorder (PTSD) on pregnancy outcomes.
Recruitment took place via prenatal clinics from three academic health systems in southeast Michigan.
This analysis included 467 diverse, nulliparous, English-speaking adult women expecting their first infants.
Data were gathered from structured telephone interviews at two time points in pregnancy and from prenatal medical records.
Contrary to our hypothesis, history of childhood maltreatment was associated with better likelihood of using adequate prenatal care. Risk for inadequate prenatal care occurred in association with the posttraumatic stress and interpersonal sensitivity that can result from maltreatment, with low alliance with the maternity care provider, and with public insurance coverage. Prior mental health treatment was associated with using adequate prenatal care.
When childhood maltreatment survivors were resilient or had used mental health treatment, they were more likely to utilize adequate prenatal care. The maternity care relationship or service delivery model (e.g., no continuity of care) as well as structural factors may adversely affect utilization among PTSD-affected survivors. Since inadequate care was associated with adverse outcomes, further studies of these modifiable factors are warranted.