A qualitative study of an integrated maternity, drugs and social care service for drug-using women

Abstract

BackgroundThe care of drug-using pregnant women is a growing health and social care concern in many countries. A specialist clinic was established offering multidisciplinary care and advice to pregnant drug users in and around Aberdeen (UK) in 1997. The majority of women stabilise and reduce their drug use. By determining the needs and views of the women more appropriate services and prevention strategies may be developed. There has been little research conducted in this area and none in Scotland.MethodsThis is a qualitative study that aimed to gain an understanding of the experiences of women drug users, seeking and receiving prenatal care and drug services from a specialist clinic. Twelve women participated in semi-structured one-to-one interviews.ResultsThe women preferred the multidisciplinary clinic (one-stop shop) to traditional prenatal care centred within General Practice. The relationships of the clients to the range of Clinic professionals and in hospital were explored as well as attitudes to Clinic care. The study participants attributed success in reducing their drug use to the combination of different aspects of care of the multi-agency clinic, especially the high level prenatal support. It is this arrangement of all aspects of care together that seem to produce better outcomes for mother and child than single care elements delivered separately. Some women reported that their pregnancy encouraged them to rapidly detoxify due to the guilt experienced. The most important aspects of the Clinic care were found to be non-judgemental attitude of staff, consistent staff, high level of support, reliable information and multi-agency integrated care.ConclusionThere is an impetus for women drug users to change lifestyle during pregnancy. The study highlighted a need for women to have access to reliable information on the effects of drugs on the baby.Further research is required to determine whether positive outcomes related to clinic attendance in the prenatal period are sustained in the postnatal period. Early referral to a specialist clinic is of benefit to the women, as they reported to receive more appropriate care, especially in relation to their drug use. A greater awareness of needs of the pregnant drug user could help the design of more effective prevention strategies.

Collaboration and integrated services for perinatal mental health: an integrative review

“…However, more revealing was the lack of literature which included the voices of women and families experiencing perinatal mental health issues. Where women’s voices were heard, these experiences related to perinatal substance misuse programmes, which predominantly reported positive outcomes for women and their children (Hall & van Teijlingen, 2006; Lefebvre et al., 2010; Mayet, Groshkova, Morgan, MacCormack, & Strang, 2008; Sword et al., 2009).…”

Experiences of mothers with substance dependence: Informing the development of parenting support

“…). A more positive view is having a healthy baby can be a significant impetus for mothers to reassess lifestyle and other behaviours (Hall & van Teijlingen , Silva et al . ).…”

“…Being a mother and having a substance dependence is a socially sensitive issue, requiring judgments about the rights and safety of children (Barnard 2005). Women frequently encounter stigma and feelings of guilt related to their past or current drug use, and the impact this may have on their children (Hall & van Teijlingen 2006, Silva et al 2013). These mothers are often identified as unfit and uncaring mothers (Kandall 2010).…”

“…There are many detrimental effects on the foetus and young child of having a mother who is currently using drugs or vulnerable to relapse (Suchman et al 2004). A more positive view is having a healthy baby can be a significant impetus for mothers to reassess lifestyle and other behaviours (Hall & van Teijlingen 2006, Silva et al 2013.…”

Opioid pharmacotherapy: Treatment, regimes, constructions and control

“…The time around the birth of a baby is frequently framed as a 'crucial' point at which interventions may be particularly efficacious, and when substance using mothers in particular might be particularly motivated to 'turn around' their lives (Hall & van Teijlingen, 2006;Klee, Jackson, & Lewis, 2002;Radcliffe, 2011). However, longitudinal research that is able to examine these changes over time has been limited.…”