Substance Use in Pregnancy: Identifying Stigma and Improving Care

Weber, Andrea N.; Miskle, Benjamin; Lynch, Alison; Arndt, Stephan; Ación, Laura

doi:10.2147/sar.s319180

Cited by 73 publications

(65 citation statements)

References 82 publications

(108 reference statements)

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“…It does not seem surprising to us that male respondents here endorse more punishment towards women using drugs. As mentioned before these women are supposed to be future mothers and to run the household and are commonly deemed to be unfit for maternity [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

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Factors influencing medical students’ attitudes towards substance use during pregnancy

et al. 2022

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Background People with substance use disorder, and pregnant women especially, are subject to a lot of stigmas, which can prevent optimal accessibility and quality of care. In this survey, we investigated attitudes of final year medical students regarding substance use during pregnancy and identified the factors that influence these attitudes. Method This cross-sectional study was conducted in 2019 and 2020 in Belgium using the short version of the “Substance Abuse Attitude Survey” questionnaire. We focused on two items regarding punishment of substance use during pregnancy. We analysed the concordance between these two, their correlation with other items (e.g. stereotyping, morality, forced withdrawal, low treatment optimism) and the association between respondents’ opinion on punishment and their sociodemographic data. Results The response rate was 65.2% (370/567 online and face-to face questionnaires). 19.2% of respondents were in favour of punishment for alcohol use (n = 353) and 15.1% for drug use (n = 356) during pregnancy. The agreement analysis between the two items showed that 14.3% of students were in favour of punishing both pregnant women who use drugs and those using alcohol. Respondents tended to be more in favour of punishment if they were male students, older, their mothers’ had a lower education level or had no personal or family history of substance use. Attitudes appeared to be more punitive among students with limited contact with people with substance use disorder (i.e. none or limited to hospital). Students intending to specialise in internal medicine were more in favour of punishment of women whereas none of those intending to specialise in psychiatry were in favour. Conclusion Our study shows that about 20% of surveyed medical students favoured punishing substance-using pregnant women. Awareness and training work seems to be necessary to ensure adequate care and support for this already vulnerable population.

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Section: Discussionmentioning

confidence: 99%

“…Pregnant women are not only stigmatised because of the potential risks to the foetus resulting from substance use but also due to perceived gender roles. Since women are socially assigned to the roles of mother and wife, a pregnant woman using drugs violates this social construct and is more likely to face stigmatisation [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Factors influencing medical students’ attitudes towards substance use during pregnancy

et al. 2022

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“…In a much broader sense, the scale and banality of toxic online engagements demonstrates the strong connection between societal stigmas and perinatal alcohol use. The stigmatization of women dealing with substance issues not only discourages mothers from utilizing important health services [ 41 , 51 ], it generates detrimental internal self-stigmas that exacerbate alcohol use during pregnancy [ 41 , 51 , 57 , 58 ]. By understanding these dynamics at play, our study emphasizes the need to address those most at-risk, specifically Twitter users that would seek to leverage the platform for assistance.…”

Section: Discussionmentioning

confidence: 99%

Understanding Alcohol Use Discourse and Stigma Patterns in Perinatal Care on Twitter

Culp

et al. 2022

Healthcare

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(1) Background: perinatal alcohol use generates a variety of health risks. Social media platforms discuss fetal alcohol spectrum disorder (FASD) and other widespread outcomes, providing personalized user-generated content about the perceptions and behaviors related to alcohol use during pregnancy. Data collected from Twitter underscores various narrative structures and sentiments in tweets that reflect large-scale discourses and foster societal stigmas; (2) Methods: We extracted alcohol-related tweets from May 2019 to October 2021 using an official Twitter search API based on a set of keywords provided by our clinical team. Our exploratory study utilized thematic content analysis and inductive qualitative coding methods to analyze user content. Iterative line-by-line coding categorized dynamic descriptive themes from a random sample of 500 tweets; (3) Results: qualitative methods from content analysis revealed underlying patterns among inter-user engagements, outlining individual, interpersonal and population-level stigmas about perinatal alcohol use and negative sentiment towards drinking mothers. As a result, the overall silence surrounding personal experiences with alcohol use during pregnancy suggests an unwillingness and sense of reluctancy from pregnant adults to leverage the platform for support and assistance due to societal stigmas; (4) Conclusions: identifying these discursive factors will facilitate more effective public health programs that take into account specific challenges related to social media networks and develop prevention strategies to help Twitter users struggling with perinatal alcohol use.

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“…Drinking is often a secretive activity in which women are resourceful and creative in managing concealment. Lack of insight and denial are common features of alcohol dependency where a woman may say she is functioning ok, failing to reconcile the impacts of alcohol use, including the health impact on a developing foetus [9]. During antenatal‐care women conceal their alcohol dependence, and midwives are not equipped to challenge concealment [6].…”

mentioning

confidence: 99%

“…However, the main reason we need to revaluate the claim "FASD is entirely preventable" is the fact that women with alcohol dependence who drink during pregnancy face significant barriers getting help. A significant barrier is stigma; internalised stigma where women believe they are a bad person and understate or deny their alcohol use leading to further isolation, and organisational stigma where health-care workers fail to effectively engage [8][9][10]. Health-care workers may fail to realise that alcohol dependence is a condition in which there is a powerful driving force to drink alcohol, and people will continue to do so even in the face of known adverse consequences [11].…”

mentioning

confidence: 99%