Pregnant and Parenting Women with a Substance Use Disorder: Actions and Policy for Enduring Therapeutic Practice

Jessup, Martha A.; Oerther, Sarah; Gance‐Cleveland, Bonnie; Cleveland, Lisa M.; Czubaruk, Kim; Byrne, Mary; DʼApolito, Karen; Braxter, Betty; Martinez-Rogers, Norma

doi:10.1016/j.outlook.2019.02.005

Cited by 8 publications

(6 citation statements)

References 16 publications

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“…An additional three states have the ability to impose civil commitment of pregnant substance using women as a means for deterring drug use [37]. However, none of these states require an assessment of parenting willingness and capacity prior to filing a child welfare report [38]. Further, case workers, probation officers and judges have been known to order women to discontinue prescribed medication assisted treatment for an OUD—the only Food and Drug Administration‐approved treatment for OUD [39,40].…”

Section: Discussionmentioning

confidence: 99%

“…Further, case workers, probation officers and judges have been known to order women to discontinue prescribed medication assisted treatment for an OUD—the only Food and Drug Administration‐approved treatment for OUD [39,40]. These practices unnecessarily place women at risk for relapse and overdose death [38]. They also lack an evidence base and must be discontinued if women's lives are to be saved and families preserved.…”

Section: Discussionmentioning

confidence: 99%

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A life‐course theory exploration of opioid‐related maternal mortality in the United States

et al. 2020

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Background and Aims Between 2007 and 2016, pregnancy-associated mortality resulting from overdose more than doubled in the United States. This study explored the circumstances surrounding maternal opioid-related morbidity and mortality, using the life-course theory as a sensitizing framework to examine how each participant's life-course contributed to her substance use, relapse, recovery or overdose. Design A mixed-methods study using semi-structured, in-depth face-to-face interviews and focus groups were conducted. Setting Texas, United States. Participants Women who had relapsed into opioid use or experienced a 'near-miss' overdose and family members of women who had died during the maternal period due to opioid overdose were interviewed (n = 99). Measurements A socio-demographic questionnaire captured participants' ethnicity, age, marital status, medical and mental health history and employment status. The Stressful Life Events Screening Questionnaire-revised (SLESQ-R) assessed lifetime exposure to trauma. Findings Women reported histories of abuse and loss of a loved one through homicide or suicide. Participants indicated that limited social support, interpersonal conflict with their partner and unaddressed mental illness made recovery more challenging. Additionally, losing their children through the child welfare system was described as punitive and placed them at greater risk for relapse and overdose. Conclusions A life-course theory approach to examining maternal opioid-related morbidity and mortality in Texas, United States reveals the complex needs of women at risk for opioid use relapse and overdose and the significant role of previous traumatic experiences.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A life‐course theory exploration of opioid‐related maternal mortality in the United States

et al. 2020

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“…For over two decades, more than 20 medical associations that advocate for both mother and newborn have published position statements and practice guidelines against punitive legislation for pregnant women with OUD (Jessup et al., 2019; National Advocates for Pregnant Women, 2018). Continued opposition to this law from nursing organizations (e.g., Tennessee Nurses Association) and grassroots advocacy groups focused on the rights of the mother (i.e., Healthy and Free TN, SisterReach) are helpful.…”

Section: Strategies For the Way Forwardmentioning

confidence: 99%

Revisiting the Fetal Assault Law in Tennessee: Implications and the Way Forward

Darlington

Compton

Hutson

2021

Policy, Politics, & Nursing Practice

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The rising prevalence of opioid use disorder (OUD) among those living in the United States has demanded a collaborative response from health care and policy spheres. Addressing OUD among pregnant women is especially difficult, given the controversies surrounding the medical and ethical balance between meeting maternal versus fetal/newborn needs. Most medical organizations discourage the criminalization of drug use in pregnancy due to the adverse public health outcomes of such an approach. Despite this recommendation, many states continue to use punitive law to address drug use in pregnancy. In 2014, the Fetal Assault Law in Tennessee (TN) became the first law in the United States to directly allow women to be prosecuted for drug use in pregnancy. Since its expiration in 2016, this law has been re-introduced several times to the TN legislature in support of permanent implementation. This article outlines the impact of the initial Fetal Assault Law on maternal/newborn health in TN and provides alternative immediate, short-term, and long-term health policy strategies through which health care providers and legislators can better advocate for the well-being of both mothers with OUD and their infants.

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“…The response to the viral pandemic shifted our focus away from a holistic view of health care, and we lost sight of the urgent need to address the ongoing opioid epidemic (Oerther & Oerther, 2019). Globally, at the national level, and in local communities across the United States (U.S.), opioid use disorder (OUD) is a fire that continues to burn out of control (Jessup et al., 2019).…”

mentioning

confidence: 99%

Leading change during the convergence of an epidemic and a pandemic

Oerther

2020

Journal of Advanced Nursing

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Pregnant and Parenting Women with a Substance Use Disorder: Actions and Policy for Enduring Therapeutic Practice

Cited by 8 publications

References 16 publications

A life‐course theory exploration of opioid‐related maternal mortality in the United States

A life‐course theory exploration of opioid‐related maternal mortality in the United States

Revisiting the Fetal Assault Law in Tennessee: Implications and the Way Forward

Leading change during the convergence of an epidemic and a pandemic

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