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Rebecca Frye DO, MPH

  • Graduate 2017
Scholarly Research Project

Screening for History of Adverse Childhood Experiences in Pregnant Patients at a Family Health Center

Rebecca Frye, DO, MPH; Maggie Judge, RN; Benjamin Skinker, M.D. and Phillip Phelps, LCSW; Nikiha Robinson, BSW


More than 50% of adults report experiencing at least one “adverse childhood event” (ACEs) as a child. Among pregnant women, this number is increased to 75%.   Research shows that experiencing ACEs increase an individual’s risk for negative health outcomes, and also increase risky behavior in pregnancy.   Identification of ACEs among pregnant women and referral for further supportive care around these risk factors should therefore impact their pregnancy and parenting experience, and help reduce the ACE risk of their children


An ACEs screening questionnaire was selected based on reading level and ease of administration.  Physicians were provided a workshop on trauma informed care prior to screening implementation.  The questionnaire was distributed to all pregnant women presenting for their initial prenatal visit.  Questionnaires were reviewed by their physician and routed to the OB coordinator.  Women who reported one or more adverse childhood event(s) were connected with Allegheny County social service resources.


Thirty patients completed the ACEs screening, with 50% (17/34) reporting at least one ACE.  Of the group screening positive and for whom names were available, 67% (8/12) were successfully contacted to refer for support services.  For a variety of reasons, only one patient successfully was linked to county based services.


A screening tool for ACEs was successfully implemented to screen pregnant patients in our FHC with minimal disruption of office flow.   The process established to connect eligible patients to support services warrants improvements.  Further study is necessary to determine perceived benefits and impact of screening and support services available to patients.