Doula Notes:

I like to find a way to give the client privacy for completing this survey in the prenatal period. For clients who prefer email, I send the ACES form to them ahead of time electronically, following the same general script.

General Script for in-person communication or email:
The Community Doula Program requires that we ask clients to consider completing the Adverse Childhood Experiences Questionnaire (ACEs). Adverse childhood experiences are potentially traumatic events that can have lasting effects on health and overall well-being. Given the high percentage of people who experience trauma or abuse in their lifetime, we ask everyone to complete this questionnaire. And just to be clear, this is not an assumption about you or your life experience.

We ask clients to complete this scale because pregnancy, labor and delivery are inherently very personal. Routine maternity and labor care can trigger past abuse and cause individuals to be unintentionally traumatized or re-traumatized. Knowing about past abuse and potential triggers can be helpful in developing our birth plan and helping us identify issues early on or before they arise.

As with all information in our program, this questionnaire is optional and, should you choose to complete it, it will be kept strictly confidential. If you choose not to fill it out, that is totally fine and will not impact the care you receive from me or the back up doula.

If I email the questionnaire:
I add at the end: "Many women prefer to fill it out privately, so I am sending it via email prior to our next prenatal visit. Whatever you decide, thanks for taking the time to consider this."

Your feedback is appreciated.