Talking to mothers about their adverse childhood experiences

Findings from a new health visitors’ study in Anglesey.

A new ground-breaking local initiative delivered in Anglesey by the Betsi Cadwaladr UHB, has seen health visitors routinely asking new mothers about the Adverse Childhood Experiences or ACEs they suffered as children.

Adverse Childhood Experiences (ACEs) are traumatic events that affect children while growing up, such as suffering child maltreatment or living in a household affected by domestic violence, substance misuse or mental illness. The routine ACE enquiry aims to better prepare individuals for parenting through providing opportunities to discuss and reflect on what impacted mother’s own experiences of childhood.

This is the first time such an approach has been piloted with health visitors in the UK. It represents a key first step towards understanding how to support mothers who have experienced ACEs in achieving positive health, wellbeing for themselves and better outcomes for them as parents. Whilst this is only an initial study, the findings from an independent evaluation by Public Health Wales are very promising.

More than 8 in 10 mothers believed it important for health visitors to have this understanding of their ACEs and over 90% of mothers considered it acceptable to provide such information to a health visitor. For over 40% of mothers with ACEs, enquiry in health visiting was the first time in their lives they had been able to discuss these experiences with a professional.

The evaluation also identified that ACE enquiry considerably improved the health visitors understanding of families, creating a greater openness and trust in their relationships with service users.  The work in Anglesey builds on a larger programme of work led by Public Health Wales that aims to address early adversity in people’s lives in order to improve their health and wellbeing throughout their life course.

Professor Bellis, Director of Policy and International Development at Public Health Wales said:

“We are delighted to have been working with health visitors in Anglesey on this important piece of work.

“All too often the harms that affect children in one generation are repeated in future generations within the same families.

“Health visitors are in an ideal position to provide the types of support that can break such cycles.

“Although this is just an initial study, the results already indicate that it is providing an opportunity for some woman to discuss problems in their own childhood for the first time and is seen as a useful development by both health visitors and new mothers.

“We are now working with Welsh Government to develop this work in other parts of Wales to help ensure all children grow up in safe and nurturing environments that provide them with the best opportunities to reach their full potential.”


  • ACES Health Visiting Report Asking about adverse childhood experiences (ACEs) in health visiting: Findings from a pilot study
  • ACEs Health Visiting Infographic Asking about adverse childhood experiences (ACEs) in health visiting - Infographic