K2 – Implementing C.H.A.N.G.E.: Strengthening Resiliency in Pregnancy

Summary

Pregnancy and childbirth is one of the most biologically, socially, and psychologically complex periods in a woman’s life (Anda, 2010). Carrying an infant in the womb is made even more difficult if a mother has endured her own trauma, potentially transmitting a vulnerability to her child’s development through maternal behavior and emotions (Hudziak, 2018). Additionally, the transition to parenthood is a general life stressor which often activates her attachment system. Symptoms of depression, anxiety, and trauma may also interfere with her ability to bond with her child (Main, 2000). Although the complexity of pregnancy and motherhood can be daunting, a mother’s resilience may mitigate the impact of these risk factors. Resilience involves being able to face challenging circumstances while also maintaining a positive mental health status (Steen, 2015). This study seeks to describe the risk of adverse birth outcomes associated with antenatal trauma and insecure attachment, as well as the impact of resilience through the incorporation of a resiliency-based intervention early in pregnancy. The intervention will target the risk of developing mood symptoms, identify positive coping strategies and highlight meaningful resources. Participants include expectant mothers in their first trimester at a rural obstetric healthcare clinic enrolled in a “New Mom’s”class. While attendance is not required, all newly expecting women enrolling in the clinic for obstetric care are strongly encouraged to attend. Mean age of participants is 28.1 years (SD = 2.03) with 44.4% of participants including first time mothers. Study design: A quasi-experimental design due to the inability to use random assignment. The study looks to assess the feasibility and acceptability of a multidisciplinary group visit to address health behaviors, presence of emotional health concerns, assess for risk of adverse experiences and initiate resiliency development for pregnancy health. Methods: Participants will complete the following measures before the class begins: Adverse Childhood Experience Questionnaire, Revised Adult Attachment Scale, the “New OB: Women’s Health History form including the Edinburg Depression Scale, and the Integrating C.H.A.N.G.E. pre-assessment. Participants will attend a 90min new mom’s class covering medical and emotional concerns associated with pregnancy, and the role adverse childhood experiences can play in coping and emotional wellbeing. Participants will complete a newly developed resiliency-based intervention (My C.H.A.N.G.E. Plan) to identify positive and protective coping strategies that they can use to support biopsychosocial wellbeing both during and after pregnancy. While early in the pilot phase, physician, clinic and patient feedback has been overwhelmingly positive. At the conclusion of the intervention, 100% of participants strongly agreed that they would access behavioral health services to support their perinatal healthcare.