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Article contents
Is perinatal substance abuse falling through the cracks?
Published online by Cambridge University Press: 25 May 2023
Abstract
Objectives:
Perinatal substance abuse (PSA) is associated with increased risk of prematurity, low birth weight, neonatal abstinence syndrome, behavioral issues and learning difficulties. It is imperative that robust care pathways are in place for these high-risk pregnancies and that staff and patient education are optimized. The present study explores the knowledge and attitudes of healthcare professionals toward PSA to identify knowledge gaps to enhance care and reduce stigma.
Methods:
This is a cross-sectional study using questionnaires to survey healthcare professionals (HCPs) working in a tertiary maternity unit (n = 172).
Results:
The majority of HCPs were not confident in the antenatal management (75.6%, n = 130) or postnatal management (67.5%, n = 116) of PSA. More than half of HCPs surveyed (53.5%, n = 92) did not know the referral pathway and 32% (n = 55) did not know when to make a TUSLA referral. The vast majority (96.5%, n = 166) felt that they would benefit from further training, and 94.8% (n = 163) agreed or strongly agreed that the unit would benefit from a drug liaison midwife. Among study participants, 54.1% (n = 93) agreed or strongly agreed that PSA should be considered a form of child abuse and 58.7% (n = 101) believe that the mother is responsible for damage done to her child.
Conclusions:
Our study highlights the urgent need for increased training on PSA to enhance care and reduce stigma. It is imperative that staff training, drug liaison midwives and dedicated clinics are introduced to hospitals as a matter of high priority.
Keywords
- Type
- Short Report
- Information
- Irish Journal of Psychological Medicine , Volume 40 , Issue 4: Themed issue on Perinatal Mental Health , December 2023 , pp. 584 - 587
- Copyright
- © The Author(s), 2023. Published by Cambridge University Press on behalf of The College of Psychiatrists of Ireland
References
Coles, CD, Good, L, Strickland, K (1992). Knowledge and attitudes of public, addicts in treatment and health care professionals about substance abuse in pregnancy. In Unpublished manuscript. Georgia Mental Health Institute. Emory University School of Medicine: Atlanta.Google Scholar
Covington, CY, Nordstrom-Klee, B, Ager, J, Sokol, R, Delaney-Black, V (2002). Birth to age 7 growth of children prenatally exposed to drugs; a prospective cohort study. Neurotoxicology and Teratology 24, 489–496.Google Scholar
Eogan, M, Gleeson, J, Ferguson, W, Jackson, V, Lawless, M, Cleary, B (2021). A decade of DOVE: multidisciplinary experience from an obstetric addiction clinic. The Irish Medical Journal 114, 352.Google Scholar
Esscher, A, Essén, B, Innala, E, Papadopoulos, FC, Skalkidou, A, Sundström-Poromaa, I, Högberg, U (2015). Suicides during pregnancy and 1 year postpartum in Sweden. British Journal of Psychiatry.Google Scholar
Government Response to the House of Commons Science and Technology Committee report of session 2010-12. (2012). Alcohol guidelines. Department of Health and Social Care (https://www.gov.uk/government/publications/government-response-to-the-house-of-commons-science-and-technology-committee-report-of-session-2010-12-alcohol-guidelines). Accessed 7 June 2022.Google Scholar
Harvey, S, Schmied, V, Nicholls, D, Dahlen, H (2015). Hope amidst judgement: the meaning mothers accessing opioid treatment programmes ascribe to interactions with health services in the perinatal period. Journal of Family Studies 21, 282–304.Google Scholar
Howard, H (2015). Reducing stigma: lessons from opioid-dependent women. Journal of Social Work Practice in the Addictions 15, 418–438.Google Scholar
Ikonomidou, C, Bittigau, P, Ishimaru, MJ, Wozniak, DF, Koch, C, Genz, K, Price, MT, Stefovska, V, Hörster, F, Tenkova, T, Dikranian, K, Olney, JW (2000). Ethanol-induced apoptotic neurodegeneration and fetal alcohol syndrome. Science 287, 1056–1060.Google Scholar
Khalifeh, H, Hunt, I, Appleby, L, Howard, L (2016). Suicide in perinatal and non-perinatal women in contact with psychiatric services: 15 year findings from a UK national inquiry. Lancet Psychiatry.Google Scholar
Knight, M, Bunch, K, Patel, R, Shakespeare, J, Kotnis, R, Kenyon, S, Kurinczuk, J (2022). Saving lives, improving mothers’ care: Core report: Lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2018-20. MBRRACE-UK.Google Scholar
Maternal Death Enquiry Ireland (2019). Confidential Maternal Death Enquiry Report 2016–2018,Google Scholar
Nichols, TR, Welborn, A, Gringle, MR, Lee, A (2021). Social stigma and perinatal substance use services: recognizing the power of the good mother ideal. Contemporary Drug Problems 48, 19–37.Google Scholar
O'Neil, E (2011). Developmental Timeline of Alcohol-Induced Birth Defects. In Embryo Project Encyclopedia
Google Scholar
Popova, S, Lange, S, Probst, C, Gmel, G, Rehm, J (2017). Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: a systematic review and meta-analysis. The Lancet Global Health 5, 290–299.Google Scholar
Reducing Harm, Supporting Recovery (2019) A health-led response to drug and alcohol use in Ireland 2017-2025 (https://www.gov.ie/en/publication/4e5630-reducing-harm-supporting-recovery-2017-2025/). Accessed 7 June 2022.Google Scholar
Richmond, I, Foster, J (2003). Negative attitudes towards people with co-morbid mental health and substance misuse problems: an investigation of mental health professionals. Journal of Mental Health 12, 393–403.CrossRefGoogle Scholar
Sood, B, Delaney-Black, V, Covington, C, N.-K., B, Ager, J, Templin, T, Janisse, J, Martier, S, Sokol, R (2001). Prenatal alcohol exposure and childhood behavior at age 6 to 7 years: I. Dose-response effect. Pediatrics 108, E34.Google Scholar
World Health Organization (2012). The WHO application of ICD-10 to deaths during pregnancy, childbirth and puerperium: ICD-MM. World Health Organization: Geneva.Google Scholar