Vulnerability of Pregnant Women Using Alcohol and Other Drugs in Low-Risk Prenatal Care

Abstract

Objective: to verify the contexts that enhance the dimensions of individual, social, and programmatic vulnerability associated with the use of alcohol and other drugs during pregnancy. Method: qualitative, descriptive, and exploratory, cross-sectional study. Participants were 38 pregnant women who used alcohol and other drugs, at a moderate and severe level, in low-risk prenatal care in the Primary Health Care of two cities in the Metropolitan Region of Maringá - Paraná. Data was collected from, December 2019 to March 2020. The Vulnerability analytical framework guided the discussion. Results: at the individual level, the vulnerability contexts were issues of gender, brown and black ethnicity/color, low education, reproductive period, and high parity. At the social level, the lack of insertion in the job market, family income below the poverty line, abusive intra-family relationships, addictive behavior in the family, and violence in the living community. In the programmatic plan, there was a low demand for health services, lack of welcoming for the treatment of drug use, screening for deficient drug use, low bond with family health teams, absence of dental, psychological, and social services, insertion in the inadequate level of prenatal care, usual risk, while they should have been classified as high risk, and mean prenatal consultations below recommended. Conclusion: the study made it possible to advance in the contexts of the vulnerability of these pregnant women. Recognizing these contexts makes it possible to formulate strategies to reduce harm and damages to maternal and fetal health related to drug use during pregnancy, leading to a favorable gestational outcome.

Motivations and expectations of pregnant women using psychoactive substances during prenatal care: phenomenological study

“… 21 The prenatal care of women who use PAS is marked by unsatisfactory reception practices, insufficient health educational information and fragile ties with the health team. 3 Other ways of caring are needed, from the perspective of human rights and harm reduction, so that assistance does not translate into violence against women and their withdrawal from services. (3.22) Identifying the factors that are associated with the use of PAS during pregnancy is essential for the identification and treatment of pregnant women to reduce risks and to improve outcomes for maternal and child health.…”

“…These women are in contexts of vulnerability due to issues of gender, race, education, abusive family relationships, addictive behavior in the family and violence. 3 …”

“…Prenatal care for pregnant women using PAS needs to be differentiated, considering that drug users deny that they use such drugs or are dependent on them; because of this, these women do not seek prenatal consultations and health care, or when they seek this help it is already too late. 3 …”

Prenatal Qualification Course: Interprofessional Constructions and Reconstructions

“…In addition to diagnosis, treatment, and routine consultations, it is essential that professionals enhance initiatives aimed at promoting and protecting maternal and child health. This thinking involves expanded and interprofessional approaches on the part of the healthcare team, as well as personal and collective commitment to lifelong learning [17][18][19][20] .…”

Curso De Qualificação Pré-Natal: Construções E Reconstruções Interprofissionais

“…Para além do diagnóstico, tratamento e consultas rotineiras é fundamental que os profissionais potencializem iniciativas voltas à promoção e proteção da saúde materno-infantil. Esse pensar envolve abordagens ampliadas e interprofissionais por parte da equipe de saúde, além de empenho pessoal e coletivo para o aprendizado ao longo da vida [17][18][19][20] .…”