Examining barriers to harm reduction and child welfare services for pregnant women and mothers who use substances using a stigma action framework

Wolfson, Lindsay; Schmidt, Rose A.; Stinson, Julie; Poole, Nancy

doi:10.1111/hsc.13335

Cited by 51 publications

(49 citation statements)

References 72 publications

(236 reference statements)

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“…Some of the risk factors associated with consuming alcohol in pregnancy related to various impacts on women's wellbeing are well‐documented, such as experiencing violence during pregnancy, pre‐pregnancy alcohol consumption patterns and inadequate access to prenatal care [ 28 ]. Contextual factors related to women's wellbeing and circumstances greatly affect alcohol use behaviour, including access to health care and substance use treatment services, education, food security and experiences of systemic racism, stigma or discrimination [ 29 , 30 ]. Though various systemic barriers such as stigma are rampant and continue to pose a challenge to enhancing pregnant women's wellbeing, there is less focus globally on how systems can address these barriers to facilitate positive outcomes [ 30 ].…”

Section: Introductionmentioning

confidence: 99%

“…Contextual factors related to women's wellbeing and circumstances greatly affect alcohol use behaviour, including access to health care and substance use treatment services, education, food security and experiences of systemic racism, stigma or discrimination [ 29 , 30 ]. Though various systemic barriers such as stigma are rampant and continue to pose a challenge to enhancing pregnant women's wellbeing, there is less focus globally on how systems can address these barriers to facilitate positive outcomes [ 30 ]. Often, approaches to prevention of alcohol use during pregnancy and FASD are child‐centred, and may include punitive approaches that tend to minimise the impacts of alcohol use and addiction on maternal wellbeing [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

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Why do women consume alcohol during pregnancy or while breastfeeding?

Popova

Dozet

Laboni

et al. 2021

Drug and Alcohol Review

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Issue. Alcohol consumption during pregnancy and breastfeeding cause adverse health outcomes to the mother and child, including Fetal Alcohol Spectrum Disorder (FASD). Approach. Systematic literature review and thematic synthesis. Original studies that contained reasons for alcohol consumption in pregnancy and while breastfeeding were included. The Mixed Methods Appraisal Tool (MMAT) and the Confidence in the Evidence of Reviews of Qualitative Research (CerQUAL) approach were utilised. The review protocol is available on PROSPERO (registration number: CRD42018116998). Key Findings. Forty-two eligible studies comprising women from 16 countries were included. Most commonly reported reasons of alcohol use in pregnancy were societal pressure and the belief that only "strong" alcohol and alcohol in large quantities is harmful. Other reasons were: a lack of awareness of adverse effects on the fetus; coping with adverse life experiences; consumption based on intuitive decision-making and influenced by personal/peer experiences; belief in the beneficial properties of alcohol; advice from medical practitioners; unwanted or unplanned pregnancy; alcohol dependence; and consumption as a cultural/traditional custom. Reasons for alcohol use during breastfeeding included the belief that alcohol stimulates breast milk production, unclear advice from medical practitioners, unawareness of the risks of infant exposure and to improve mood and celebrate events. Implications. Understanding the context of reasons for alcohol use in pregnancy is crucial for implementing prenatal health education, and preventing FASD and other adverse maternal and child health outcomes. Conclusion. Individual beliefs, knowledge/advice, culture and personal circumstances influence alcohol use in pregnancy. Data are limited for reasons surrounding alcohol use while breastfeeding.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Why do women consume alcohol during pregnancy or while breastfeeding?

Popova

Dozet

Laboni

et al. 2021

Drug and Alcohol Review

View full text Add to dashboard Cite

show abstract

“…Studies of mothers in substance use treatment demonstrate a complex relationship between motherhood and substance use treatment and recovery. Although motherhood and caring for children are often described as a critical motivating factor for seeking treatment and reducing substance use [ 42 , 155 ], mothers are also more likely to conceal their substance use and avoid seeking help because of fears of losing their children [ 156 , 157 ]. Loss of child custody may also lead to relapse in mothers because of the stress and trauma of child removal [ 158 , 159 ].…”

Section: Discussionmentioning

confidence: 99%

Adaptive Text Messaging for Postpartum Risky Drinking: Conceptual Model and Protocol for an Ecological Momentary Assessment Study

Dauber¹,

Beacham²,

Hammond³

et al. 2022

JMIR Res Protoc

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Background Risky drinking is prevalent among women of childbearing age. Although many women reduce their drinking during pregnancy, more than half return to prepregnancy levels during the early postpartum period. Risky drinking in new mothers may be associated with negative child and maternal health outcomes; however, new mothers are unlikely to seek treatment for risky drinking because of stigma and fear of child protective service involvement. SMS text messaging is a promising approach for reaching non–treatment-seeking new mothers at risk because of risky drinking. SMS text messaging interventions (TMIs) are empirically supported for alcohol use, but a tailored intervention for new mothers does not exist. This study aims to fill this gap by developing a just-in-time adaptive TMI for postpartum risky drinking. Objective The objectives of this paper are to present a preliminary conceptual model of postpartum risky drinking and describe the protocol for conducting an ecological momentary assessment (EMA) study with new mothers to inform the refinement of the conceptual model and development of the TMI. Methods This paper presents a preliminary conceptual model of postpartum risky drinking based on the motivational model of alcohol use, social cognitive theory, and temporal self-regulation theory. The model proposes three primary intervention targets: motivation, self-efficacy, and self-regulation. Theoretical and empirical literature in support of the conceptual model is described. The paper also describes procedures for a study that will collect EMA data from 30 participants recruited via social media and the perinatal Central Intake system of New Jersey. Following the baseline assessment, EMA surveys will be sent 5 times per day for 14 days. The assessment instruments and data analysis procedures are described. Results Recruitment is scheduled to begin in January 2022 and is anticipated to conclude in March 2022. Study results are estimated to be published in July 2022. Conclusions The study findings will enhance our understanding of daily and momentary fluctuations in risk and protective factors for risky drinking during the early postpartum period. The findings will be used to refine the conceptual model and inform the development of the TMI. The next steps for this work include the development of intervention components via an iterative participatory design process and testing of the resulting intervention in a pilot microrandomized trial. International Registered Report Identifier (IRRID) PRR1-10.2196/36849

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“…While children with TSE were not at increased odds to receive cash assistance, this is likely because only about 3% of all children, irrespective of their home TSE status, received this type of assistance. However, research suggests that some families may not apply for assistance due to the associated stigma or fear or mistrust of child welfare services [ 33 ]. Lack of observed differences between child home TSE status and WIC program benefits may be because we examined 6–11-year-old children who were not eligible for WIC past the age of five years [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Financial Insecurity and Food Insecurity among U.S. Children with Secondhand and Thirdhand Smoke Exposure

Mahabee‐Gittens

King

Vidourek

et al. 2022

IJERPH

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Objectives: Smokers with financial and food insecurity may find it difficult to quit smoking and reduce their children’s tobacco smoke exposure (TSE). The objective was to examine the associations between child TSE and financial and food insecurity among U.S. school-aged children. Methods: We examined the 2018–2019 National Survey of Children’s Health data on 17,484 children 6–11 years old. Children were categorized into TSE groups: (1) No TSE: did not live with a smoker; (2) thirdhand smoke (THS) exposure alone: lived with a smoker who did not smoke inside the home; or (3) secondhand smoke (SHS) and THS exposure: lived with a smoker who smoked inside the home. We conducted weighted logistic, ordinal, and linear regression analyses to assess the relationships between child TSE status and financial and food insecurity, adjusting for covariates. Results: Overall, 13.1% and 1.8% of children had THS exposure alone and SHS and THS exposure, respectively. Compared to children with no TSE, children with THS exposure alone were at 2.17 increased odds (95% CI = 1.83, 2.58, p < 0.001) and children with SHS and THS exposure were at 2.24 increased odds (95% CI = 1.57, 3.19, p < 0.001) of having financial insecurity. Children with THS exposure alone were at 1.92 increased odds (95% CI = 1.58, 2.33, p < 0.001) and children with SHS and THS exposure were at 2.14 increased odds (95% CI = 1.45, 3.16, p < 0.001) of having food insecurity. Conclusions: Children with TSE are at increased risk of experiencing financial and food insecurity. When developing tobacco interventions, a holistic approach to tobacco control that addresses ways to decrease financial and food hardships may improve outcomes.

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Examining barriers to harm reduction and child welfare services for pregnant women and mothers who use substances using a stigma action framework

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 51 publications

References 72 publications

Why do women consume alcohol during pregnancy or while breastfeeding?

Why do women consume alcohol during pregnancy or while breastfeeding?

Adaptive Text Messaging for Postpartum Risky Drinking: Conceptual Model and Protocol for an Ecological Momentary Assessment Study

Financial Insecurity and Food Insecurity among U.S. Children with Secondhand and Thirdhand Smoke Exposure

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