Context: Pregnant Veterans are at a high risk of having experienced a wide array of trauma, which can detrimentally affect health outcomes for both the mother and child. VA-enrolled Veterans have maternity benefits through the peripartum period, but the VA does not offer on-site obstetric services. By understanding the systemic barriers maternity care staff and clinicians face as they support Veterans receive non-VA pregnancy care and transition back to VA primary care after delivery, this study sheds light on potential maternity care policy and culture change recommendations to assist Veterans to access trauma-informed health care. 

Objective: The objective of this study is to explore maternity care coordination staff and clinicians’ trauma-informed approach to caring for Veterans during the peripartum period.  

Study Design: Semi-structured qualitative interviews

Dataset: We conducted five in-depth interviews with key maternity care staff informants affiliated with the Palo Alto VA. All participants were selected through an intentional sampling approach.

Main and Secondary Outcome Measures: Identification of facilitators and potential areas of improvement related to trauma-informed care in the peripartum period

Anticipated Results: Participants discussed facilitators and areas of improvement around patient, clinician/staff, and system factors:

1. At the patient-level:
- Facilitators: trust in health care staff
- Areas of improvement: physical and emotional safety in clinic; lack of control during care coordination
2. At the clinician/staff level:
- Facilitators: patient-centered care, trust-building, education, interdependence across specialities, and cultural humility
-Areas for improvement: avoiding re-traumatization; giving patients more autonomy; universal screening; active follow-up
3. At the system-level:
- Facilitators: VA’s experience and expertise in caring for Veterans who have experienced trauma; VA’s breadth of services provided; VA Maternity Care Coordination program
- Areas for improvement: More equitable policies at the VA system level that demonstrate a commitment to reproductive and racial justice

Conclusions: Participants articulated existing factors that facilitate a trauma-informed health care environment for Veterans. Participants also recommended areas of improvement which can inform future policies and initiatives to improve care of Veterans during the peripartum period.