Trauma Informed Care in the Perinatal Period

Seng Julia

Description

The past two decades have seen a convergence of findings across studies of traumatic stress, attachment, and neurobiology, confirming the crucial importance of well-being within the mother-infant dyad for life-long mental and physical health, and for reaching the fullest developmental potential. It is now established that there are intergenerational cycles of childhood maltreatment and psychiatric vulnerability that warrant a prevention approach. Pregnancy is a crucial point of intersection between generations. During pregnancy, women with a childhood maltreatment history have a 12-fold increased risk of posttraumatic stress disorder (PTSD). Although awareness of the need for trauma-informed care and trauma-specific interventions is increasing in the fields of addiction and mental health treatment in particular, there are no front-line programmes for the childbearing year that address maltreatment-related PTSD. This edited collection addresses the issues of intergenerational cycles of childhood maltreatment and psychiatric vulnerability by providing a resource to facilitate incorporating trauma-informed care and trauma-specific interventions into maternity services with an emphasis on improving outcomes for childbearing women with a childhood maltreatment history.The book will prove of use to those training for or working in child protection and nursing.

Sujets

• Médecine
• Child protection
• Child health nursing

Informations

• Publié par: Dunedin Academic Press
• Date de parution: 29 octobre 2015
• Nombre de lectures: 0
• EAN13: 9781780465456
• Langue: English

Extrait

PROTECTING CHILDREN AND YOUNG PEOPLE SERIES EDITORS
JOHN DEVANEY
School of Sociology, Social Policy and Social Work, Queen’s University Belfast
and JULIE TAYLOR
School of Health and Population Sciences, University of Birmingham
and SHARON VINCENT
Social Work and Communities, Northumbria University, Newcastle
Trauma Informed Care in the Perinatal Period
Edited by
Julia Seng
Professor of Nursing, Obstetrics and Women’s Studies at the University of Michigan, USA
and Julie Taylor
NSPCC Professor of Child Protection, School of Health and Population Sciences, University of Birmingham, UK
CONTENTS
The Contributors
Glossary of Abbreviations
Chapter 1 Why trauma informed care in the perinatal period? – Julia Seng
Chapter 2 What is trauma informed care and why is it important? – Chris Cuthbert and Julia Seng
Chapter 3 What theories explain intergenerational patterns? – Julia Seng and Julie Taylor
Chapter 4 How does focusing on post-traumatic stress disorder shift perinatal mental health paradigms? – Mickey Sperlich
Chapter 5 How does traumatic stress affect pregnancy and birth? – Julia Seng
Chapter 6 The postnatal period – opportunities for creating change – Heather Rowe, Julia Seng, Catherine Acton and Jane Fisher
Chapter 7 What does trauma informed perinatal care look like? – Mickey Sperlich and Julia Seng
Chapter 8 Where are we on the journey towards trauma-specific interventions and treatments for the perinatal period? – Chris Cuthbert
Chapter 9 What are the next steps for trauma informed care in education and research? – Kristen R. Choi and Julie Taylor
References
Index
THE CONTRIBUTORS
Seng, Sperlich, Fisher, Rowe, Cuthbert and Taylor have been collaborating across countries for a number of years on child abuse, stress and the early years (CASEY). For this book the CASEY collaboration was joined by graduate students Acton and Choi.
Australia
Jane Fisher , BSc (Hons), PhD MAPS, is Jean Hailes Professor of Women’s Health and Director of the Jean Hailes Research Unit in the School of Public Health and Preventive Medicine at Monash University. She has been Consultant Clinical Psychologist to Masada Private Hospital Mother Baby Unit, which is a twenty-bed, residential, early parenting service in Melbourne, since 1996.
Heather Rowe , BSc (Hons), PhD, is a health scientist with a background in the biological and psychological sciences and health promotion. She is Senior Research Fellow in the Jean Hailes Research Unit School of Public Health and Preventive Medicine at Monash University. Her research interests are in mental health during the perinatal life phase, including the impact of trauma on women and their health caregivers.
Catherine Acton , BSc, GDipEdPsych, MPsych (Clinical), MAPS, is a clinical psychologist working in a perinatal emotional health team at a large public maternity hospital in Melbourne, Australia. She has recently completed a PhD that investigated the impact of traumatic life events on mental health in pregnancy and adjustment following childbirth. She has a particular interest in the impact of early abuse and neglect experiences upon the transition to parenthood.
United States of America
Julia S. Seng , PhD, CNM, RN, FAAN, one of the volume editors, is a nurse-midwife and Professor of Nursing, Obstetrics, and Women’s Studies at the University of Michigan in the United States. Her research focuses on the effects of post-traumatic stress disorder (PTSD) on women’s health and childbearing outcomes, biological mechanisms, and interventions.
Mickey Sperlich , PhD, MSW, CPM, is an experienced midwife and Assistant Professor of Social Work at the State University of New York at Buffalo. She researches the effects of trauma and mental health challenges on childbearing and parenting and develops trauma informed perinatal interventions.
Kristen R. Choi , BSN, RN, is a nurse and PhD student at the University of Michigan School of Nursing. Her research examines trauma-related psychopathology, self-dysregulation, and health service delivery for children who have been abused and exploited.
United Kingdom
Chris Cuthbert is the Head of Strategy and Development for Children Under One at the UK’s National Society for the Prevention of Cruelty to Children (NSPCC). He is in charge of fostering prevention initiatives for the zero-to-ones, including developing an evidence base for programmes that are showing the greatest promise.
Julie Taylor , PhD, RN, MSc, BSc (Hons), FRCN, is an editor in this Dunedin Academic Press series on Protecting Children and Young People. She is Professor of Child Protection in the School of Health and Population Sciences at the University of Birmingham. Her research is centred around families with complex needs.
GLOSSARY OF ABBREVIATIONS AAP American Academy of Pediatrics ACE Adverse Childhood Experiences ACNM American College of Nurse-Midwives ACOG American College of Obstetricians and Gynecologists APA American Psychiatric Association CASEY Child Abuse, Stress and the Early Years CBT Cognitive Behavioural Therapy CFT Compassion Focused Therapy DSM Diagnostic and Statistical Manual of Mental Disorders EMDR Eye Movement Desensitization and Reprocessing FNP Family Nurse Partnership HPA Hypothalamic-pituitary-adrenal LHT Life History Theory NCTIC National Center for Trauma-Informed Care NICE The National Institute for Health and Clinical Excellence NSPCC National Society for the Prevention of Cruelty to Children OECD Organization for Economic Cooperation and Development PIP Parent–Infant Psychotherapy PTSD Post-Traumatic Stress Disorder PUP Parents Under Pressure SAMHSA Substance Abuse and Mental Health Services Administration STACY Stress, Trauma, Anxiety and the Childbearing Year WHO World Health Organization
CHAPTER 1
Why trauma informed care in the perinatal period?
Julia Seng, University of Michigan
Introduction
Traumatic stress, a component of both toxic stress and intergenerational patterns, adversely affects population health. Traumatic stress caused by child maltreatment is often unresolved for women prior to pregnancy, with implications for her obstetric experience and subsequent relationship with her child. In order to improve perinatal outcomes and long-term health for individuals and at the population level, an emphasis on psychosocial care that is informed by a knowledge about trauma is crucial.
Professionals who work toward optimising child welfare, development and health know that preventing maltreatment is crucial both for individual outcomes and for society. Professionals who care for childbearing women in perinatal settings also realise that it is important to get the mother–infant dyad off to the best possible start. In the past, service delivery to pregnant women has been weighted towards a medical model, giving highest priority to surveillance and treatment for high-risk obstetric conditions and providing maternal support services as a secondary level of care added to address needs of vulnerable women. Currently, this prioritisation is shifting to put medical and psychosocial care on a more even footing because it is becoming clearer to all that some of the intransigent perinatal, lifespan health, developmental and social problems have intergenerational patterns that start in pregnancy.
Research across numerous academic disciplines is now demonstrating that childhood maltreatment trauma is a very important factor in patterns of deprivation, psychiatric vulnerability, ill health and violence. These problems warrant primary prevention for the infant to begin in utero. This presents an opportunity for child welfare professionals and maternity professionals to collaborate in creating new service delivery models that provide trauma informed care across the perinatal period – across pregnancy, birth and the ‘fourth trimester’ that includes the early weeks of parenting.
This book takes a broad definition of child maltreatment, in accordance with the World Health Organization policy:
Child maltreatment, sometimes referred to as child abuse and neglect, includes all forms of physical and emotional ill-treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child’s health, development or dignity. Within this broad definition, five subtypes can be distinguished – physical abuse; sexual abuse; neglect and negligent treatment; emotional abuse; and exploitation (WHO 2014).
The purpose of this book is to provide an overview of information that child welfare and perinatal professionals can use to move towards providing trauma informed care and developing trauma-specific interventions to improve intergenerational trajectories.
In this first chapter we sketch what this new knowledge includes and provide an overview of what follows. More detail about the explanatory concepts prefaced here are dealt with in subsequent chapters.
A convergence of knowledge
Psychosocial care in the perinatal period is the next frontier in advancing maternal and infant outcomes – and indeed the wellbeing of society at large (Shonkoff et al ., 2012; Renfrew et al ., 2014). That is a rather sweeping statement. But by the time we lay out the information that supports the statement, we think you will agree. Likely you also will allow that we have ‘known’ most of this information for a long time (Herman, 1992). What is true at this moment, as we write in mid-2015, is that there now is a critical mass of research findings to provide a strong impetus to strengthen psychosocial perinatal care. These come from studies conducted in numerous populations and by asking questions from biological, psychological and social standpoints. Synthesis of results provides an impetus to act on what we have surmised for a long time.
Medical advances are not enough to improve the health of the population
Medical approaches to preventing and treating obstetric complications continue to make advances, but in sma