Substance use in pregnancy

Wong, Suzanne; Ordean, Alice; Kahan, Meldon

doi:10.1016/j.ijgo.2011.06.001

Cited by 48 publications

(7 citation statements)

References 133 publications

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“…Substance use during pregnancy and early parenthood is seen in Canada and most other countries as a significant public health problem. Infants with exposure to substances in utero are believed to face multiple health and social challenges, including Fetal Alcohol Spectrum Disorder (FASD), neonatal withdrawal, and ultimately, higher incidence of placement in foster care and greater risks of perceived and actual child abuse [ 1 , 2 ]. In Canada it is thought that anywhere between 1 in 500 to 1 in 3000 children are born with Fetal Alcohol Syndrome (FAS) [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Fear of losing their children through Child Protection Services (CPS) interventions and apprehensions is another major barrier that stops mothers who use substances from reaching out for support, particularly when there are other compounding marginalisations such as lack of housing and racism [ 17 , 21 , 22 ]. Issues such as non-disclosure, stigma, harm reduction, and trauma have become prominent in recent literature and researchers are increasingly developing guidelines for health practitioners to use supportive and nonjudgmental practices as well as sensitive and equitable screening tools [ 2 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

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

Benoit

Magnus

Phillips³

et al. 2015

Int J Equity Health

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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.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Benoit

Magnus

Phillips³

et al. 2015

Int J Equity Health

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“…higher in this population (Jambert-Gray, Lucas, & Hall, 2009). According to Isemann et al (2011), using maternal breast milk can decrease length of stay.…”

Section: Nonpharmacologic Therapymentioning

confidence: 85%

Neonatal Abstinence Syndrome

Sublett¹

2013

McN: The American Journal of Maternal/Child Nursing

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Neonatal Abstinence Syndrome (NAS) occurs in infants exposed to opiates or illicit drugs during pregnancy. It can be severe and cause long hospital stays after birth and with symptoms up to 6 months after birth. Pharmacologic interventions are commonly used as treatment for NAS; however, their safety and efficacy are not fully recognized. Pharmacologic treatments for NAS include medications such as methadone, buprenorphine, morphine, and phenobarbital. Nonpharmacologic interventions and complementary therapies have been documented in neonates. However, there are gaps in the literature regarding use of these therapies for neonatal withdrawal. This article provides an overview of the possible risks, benefits, and outcomes of pharmacologic and complementary therapies in the neonatal population, and illustrates the gaps in knowledge related to their use for neonatal withdrawal.

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“…gonorrhea, chlamydia) during the initial prenatal care visit and repeated in the third trimester due to high rates of prostitution and the exchange of sex for drugs. 45, 46 HCV is especially prevalent due to high rates of intravenous opioid use and education and counseling regarding HCV risk factors and transmission should occur during prenatal care visits. 19, 45, 47, 48 Prenatal surveillance of HCV should include HCV genotype identification, monitoring of liver transaminases to evaluate for evidence of liver inflammation and/or injury and referral to hepatology to discuss disease status and treatment options after delivery.…”

Section: Antepartum Care and Managementmentioning

confidence: 99%

Caring for Opioid-dependent Pregnant Women

Krans

Cochran²,

Bogen³

2015

Clinical Obstetrics &Amp; Gynecology

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Pregnancy is an opportune time to identify opioid dependence, facilitate conversion to opioid maintenance treatment, and coordinate care with specialists in addiction medicine, behavioral health and social services. Comprehensive prenatal care for opioid dependent women involves the evaluation and management of co-occurring psychiatric disorders, polysubstance use, infectious diseases, social stressors and counseling regarding the importance of breastfeeding, contraception and neonatal abstinence syndrome. While the complex psychiatric, social and environmental factors faced by this population pose significant challenges to obstetric care providers, the development of strong patient-provider relationships can facilitate the ability to deliver efficient and effective health care during pregnancy.

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Substance use in pregnancy

Cited by 48 publications

References 133 publications

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

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

Neonatal Abstinence Syndrome

Caring for Opioid-dependent Pregnant Women

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