Complicating the dominant morality discourse: mothers and fathers’ constructions of substance use during pregnancy and early parenthood

Abstract

IntroductionConsumption of substances is a highly controversial behaviour, with those who do so commonly viewed as deviants, even criminals, or else as out of control addicts. In other work we showed that the use of substances by women who are pregnant or have recently become parents was mainly viewed by health and social care providers as morally wrong. Problematic substance use was framed through the narrow lens of gendered responsibilisation, resulting in women being seen primarily as foetal incubators and primary caregivers of infants.MethodsIn this follow-up paper we examine descriptive and qualitative data from a convenience sample of biological mothers and fathers (N = 34) recruited as part of a larger mixed methods study of the development and early implementation of an integrated primary maternity care program. We present a description of the participants’ backgrounds, family circumstances, health status, and perception of drug-related stigma. This is succeeded by a thematic analysis of their personal views on substance use during both pregnancy and the transition to parenthood.ResultsOur results show that while many mothers and fathers hold abstinence as the ideal during pregnancy and early parenting, they simultaneously recognize the autonomy of women to judge substance use risk for themselves. Participants also call attention to social structural factors that increase/decrease harms associated with such substance use, and present an embodied knowledge of substance use based on their tacit knowledge of wellness and what causes harm.ConclusionsWhile these two main discourses brought forward by parents concerning the ideal of abstinence and the autonomy of women are not always reconcilable and are partially a reflection of the dissonance between dominant moral codes regarding motherhood and the lived experiences of people who use substances, service providers who are attuned to these competing discourses are likely to be more effective in their delivery of health and social services for vulnerable families. More holistic and nuanced perspectives of health, substance use, and parenting may generate ethical decision-making practice frameworks that guide providers in meeting and supporting the efforts of mothers and fathers to achieve well-being within their own definitions of problematic substance use.

Reframing Fetal Alcohol Spectrum Disorder: Studying Culture to Identify Communication Challenges and Opportunities

“…Our analysis also supported previous research that has shown that when thinking about pregnancy, and especially FASD, people implicitly compare women to vessels (see, for example, Benoit et al, 2015;Rabuzzi, 1994). In this way, participants in this research saw pregnancy as a fundamental change in a woman's identity.…”

“…Another line of research focuses on the roles of public health professionals and service providers in influencing women's behavior (Benoit et al, 2015;Pei, Leung, Jampolsky, & Alsbury, 2016). Studies have analyzed content in existing public health campaigns with a focus on professionals' conceptualizations of problematic alcohol use among clients (Benoit et al, 2015;Ryan & Bonnett, 2006).…”

“…Studies have analyzed content in existing public health campaigns with a focus on professionals' conceptualizations of problematic alcohol use among clients (Benoit et al, 2015;Ryan & Bonnett, 2006). Others have examined communications between service providers and clients, focusing on interpersonal service delivery methods when working with people who have FASD, pregnant women, mothers, and women who drink alcohol (Stewart & Glowatski, 2014).…”

“…Among them, first, women are consistently portrayed as stewards of, and responsible for, their children's wellbeing. For example, pregnant women are often depicted as vessels, responsible for providing a safe "home" for unborn children (Benoit, Magnus, Phillips, Marcellus, & Charbonneau, 2015;Bell, McNaughton, & Salmon, 2009;Rabuzzi, 1994). FASD is most often discussed as a product of a woman's personal decisions with little to no attention paid to social or environmental factors.…”

Puérperas dependientes de crack: dificultades y facilidades afrontadas en el cuidado al recién nacido

“…Geralmente, são mulheres usuárias de crack que se encontram em situação de vulnerabilidade social, com rompimento dos vínculos familiares, percebidas como falha de caráter (21). A perda do vínculo familiar pode fazer com que vivam em situação de moradia de rua.…”