Prenatal clinicians’ perspectives on trauma-informed care competency and training

BACKGROUND: Prenatal clinicians express willingness to provide trauma-informed care (TIC) yet report barriers in translating TIC principles into practice. This study explored prenatal clinicians' perspectives on TIC competency and training, with the goal of identifying actionable strategies to strengthen training approaches in prenatal care. METHODS: A mixed methods study design was employed. A purposive sampling technique was used to recruit prenatal clinicians with varied professional roles, years of practice, and TIC training. Semi-structured interviews were conducted with 23 prenatal clinicians that were analyzed using inductive thematic analysis. RESULTS: The majority of the sample comprised female clinicians (95.7%) with an average of 11.8 ± 9.4 years in practice. Most participants were certified nurse-midwives (52.2%). While 60.9% of participants reported prior TIC training, one-third (34.8%) reported attending a TIC-specific seminar or conference in the past two years. Quantitative results identified a gap in translating TIC knowledge into practice despite favorable attitudes towards TIC. We identified two thematic domains: (1) TIC competency, and (2) training and education. Under TIC competency, sub-themes included prenatal clinician support of TIC and lack of competence. Training and education sub-themes included inadequate TIC training, impact evaluation, TIC practice gap and inconsistent quality of care, barriers to training, and existing resources and opportunities. CONCLUSIONS: Findings highlight the importance of TIC yet current training is inadequate, fragmented, and insufficiently tailored to the prenatal context. Future research should examine TIC training models in prenatal care, assessing the long-term impact on clinicians and patients and how organizational and cultural contexts influence sustainable, system-wide adoption.