Resilient Parenting Project: Exploring the Role of OB/GYN Clinics in the Prevention of the Intergenerational Transmission of Child Maltreatment

Background/Purpose: The majority of children who come to the attention of child protective services are referred for neglect, predominantly due to : (1) failure to provide or meet the basic needs of the child; and (2) failure to supervise or ensure a child’s safety within and outside the residence given the child’s  development. Prior work examining intergenerational patterns of maltreatment have observed maternal childhood experiences of abuse and neglect to be associated with a higher risk of neglect toward one’s child. In the feasibility phase of a study on intergenerational patterns of maltreatment, this interdisciplinary research team  partnered with geographically diverse OB/GYN clinics to ask: 1) Is screening for maternal childhood experiences of maltreatment among pregnant patients from geographically diverse OB/GYN clinics feasible?; 2) What is the prevalence of maternal childhood maltreatment experiences and the extent of resilience among pregnant patients ?; and, 3) What are the relationships among maternal childhood experiences of maltreatment, resilience, and demographic characteristics?

Methods: Over a six month period, 418 expectant patients at four ob/gyn clinics across two Midwestern cities were successfully recruited to participate in the study by completing a brief, self-report assessment developed by the research team. All participants completed the voluntary and anonymous assessment as a part of their new patient intake paperwork. Forms were available in English and Spanish. Participants were provided with a brief written description of the study and a phone number to contact a bilingual resource navigator if they were interested in support services. Descriptive analyses were used to establish the prevalence of maternal childhood experiences of maltreatment, the extent of resilience, and the demographic characteristics of the sample. .

Results: Over 6 months, we sampled 418 pregnant women at intake in four geographically distinct OB/GYN clinics. Approximately 33% of participants indicated at least one of seven childhood maltreatment experiences. Mean resilience score was 17.9 (SD=2.7) for respondents with no childhood maltreatment experiences and 18.5 (SD=2.6) for respondents with at least one experience (p=.093). Bivariate analyses indicated that pregnant women who experienced financial hardships, lower levels of education, unstable housing, or no private insurance were more likely to report at least one childhood maltreatment experience..  In addition, pregnant women who reported having no medical insurance (but sought prenatal services) and financial hardship were associated with significantly higher resilience scores on average. No significant differences in childhood maltreatment experiences or resilience were observed across the four sampled clinics.

Conclusion/Implications: Based on the observed prevalence of maternal experiences of child maltreatment, screening within OB/GYN clinics can help with early identification of high-risk populations for intergenerational maltreatment. Socio-economic factors appear to consistently correlate with any report of childhood maltreatment; however, two of these socio-economic factors (i.e., no insurance and financial hardship) also correlate with higher resilience scores on average for women seeking prenatal care in the face of these economic adversities. Routine screenings and referral to social workers for women seeking prenatal services may represent a promising avenue for maltreatment prevention within OB/GYN settings and warrants further study.