How a trauma-focused prenatal group program may interrupt the generational cycle of trauma

By Dr. Lise Milne

What if early intervention – really early intervention – could interrupt inter-generational cycles of trauma?

Emerging research confirms that experiences in utero and ‘the first 1000 days’ disproportionately affect the development of biological systems that shape the structural foundation for the developing brain. An infant’s experience of toxic stress can result in high levels of hormones such as cortisol, which has been found to significantly disrupt the formation of the brain and other organs and systems. Exposure to toxic stressors such as abuse, neglect, or violence – whether directly or through their parent – creates risk for lifelong neurodevelopmental, psychopathological, behavioral, and physical health problems.

In contrast, early-life nurturance has been found to promote cognitive, emotional, and resilience development. Though exposure to varying degrees of adversity is normal, protection and support from healthy caregivers allow the infant’s developing brain to regulate its stress response system. Stable and interactive relationships are crucial because they serve as a protective buffer, allowing the brain to form healthy neural circuits.

Thus, parents supported during the perinatal phase will be more likely to provide the environment (experiences) necessary for optimal neurodevelopment. Moreover, interventions that capitalize on the increased ‘neuroplasticity’ that occurs in the brains of parents during pregnancy and post-partum can help the transition to parenthood.

The Benefits of Preventive Interventions
It is estimated that every $1 spent on early childhood yields up to a $16 return, yet there is a notable lack of funding dedicated to research and practice approaches to early childhood adversity and its association with poor mental health outcomes. Affecting an alarming 1.2 million children and 7.5 million young adults, costs related to child mental health issues are exorbitant, estimated at $50 billion annually in Canada alone. 

Despite this evidence, there are few interventions designed for expectant caregivers who experienced childhood trauma. With support from the Saskatchewan Health Research Foundation’s Establishment Grant program, Dr. Milne and her multi-disciplinary team are attempting to fill this gap by implementing and evaluating a prenatal group program specifically designed for expectant parents who experienced childhood trauma.

Supporting the Transition to and Engagement in Parenthood (STEP)
The STEP program was recently developed, implemented, and evaluated by Dr. Nicolas Berthelot in Quebec. Over 9 weeks, STEP participants reflect on childhood trauma, emotions, and their impact on pregnancy and parenting. Participants are supported in mentalizing their trauma, which has been shown to decrease psychopathology, increase sensitivity toward their infants, and increase a sense of commitment to parenthood. STEP also supports the development of healthy emotion regulation strategies.

Dr. Milne hopes that the program will yield positive impacts for participants in Saskatchewan, including significant decreases in psychological distress – common among all expectant parents, particularly those who experienced childhood adversity – and the development of new insights and changes in the ways they feel about themselves, their past, and parenthood. Dr. Milne is currently consulting with knowledge users and persons with lived experience to determine the optimal conditions for the program’s implementation, set to occur in 2024.


The University of Regina is a Member of Research Canada: An Alliance for Health Discovery and Sponsor of the Parliamentary Health Research Caucus Buffet Luncheon, Reinventing Children’s Health through Game-Changing Pediatric Research and Innovation. Visit to learn more.