Maternal Adverse Childhood Experiences and Non-Live Births

Around 62 percent of adults in the United States have endured at least one type of Adverse Childhood Experience (ACE), and 25 percent of women reported experiencing three or more ACEs in their lifetime. This study explored whether maternal exposure to ACEs was associated with pregnancy loss or abortion, utilizing the National Longitudinal Study of Adolescent to Adult Health (known as Add Health) to explore this association. I found that cumulative ACEs, assessed through either the conventional ACE scale (reflecting 10 types of ACEs) or the extended ACE scale (reflecting 14 types of ACEs), are associated with a higher likelihood of having an abortion. However, my study found no significant association between ACEs and pregnancy loss during their first or all pregnancies. In examining the independent effects of ACE types, maternal exposure to emotional abuse increased the risk of pregnancy loss as well as the likelihood of having an abortion. Exposure to physical abuse, sexual abuse, and emotional neglect also increased the likelihood of having an abortion. Age at the time of pregnancy (older age compared to younger) and having a chronic health condition increased the risk of pregnancy loss. Maternal childhood socioeconomic status (SES) influenced exposure to ACEs, socio-economic conditions, and subsequently, the risk of pregnancy loss or likelihood of having an abortion. My study found that lower childhood SES is associated with an early age at the time of pregnancy, which in turn increases the chances of having an unintentional pregnancy and increasing the likelihood of having an abortion. The second pathway suggests that lower childhood SES increases the likelihood of being unmarried, which increases the chances of unintended pregnancies, subsequently increasing the likelihood of having an abortion. The findings suggest that there is a need to introduce interventions to reduce childhood SES disparities in order to decrease the risk of ACEs, and subsequently reduce future issues pertaining to maternal health. Childhood SES disparities reflect structural inequalities that often limit access to resources, education, and healthcare, perpetuating a cycle of disadvantage. Moreover, structural inequalities hinder women's autonomy over their reproductive decisions, which is essential for breaking the cycle of intergenerational inequality. Without addressing these deep-rooted structural issues, efforts to reduce SES disparities, mitigate ACEs, and enhance reproductive autonomy will face significant barriers, ultimately perpetuating the cycle of inequality and its adverse effects on maternal and child health.