“A Résumé for the Baby”: Biosocial Precarity and Care of Substance-Using, Pregnant Women in San Francisco

Premkumar, Ashish; Kerns, Jennifer L.; Huchko, Megan J.

doi:10.1007/s11013-019-09634-9

Cited by 6 publications

(9 citation statements)

References 52 publications

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“…We suggest prenatal care providers be trained to identify at-risk women for experiences of IPV/DV and SUD by using evidence-based procedures for screening, following by provision of short-term mechanisms of support and proactive referral to comprehensive services for violence and substance use treatment. We advocate against punitive approaches with pregnant women who are using substances, as these have been associated with rising trends of CS in the region [ 30 ]. California is one of three states in the U.S. along with Hawaii and Washington State that does not consider fetal exposure to drugs as evidence of child abuse, but requires postnatal drug assessment of newborns.…”

Section: Discussionmentioning

confidence: 99%

“…Instead of criminalization, research strongly suggests women-centered approaches are more beneficial for both the mother and the baby. Interventions for pregnant women with SUD can be strengthened by input from both prenatal care providers and those from more of the criminal justice/social welfare space (e.g., CPS case managers, prosecutors) so long as mothers are provided opportunity to demonstrate their parental capacity and interest [ 30 ]. Comprehensive case management services for social vulnerabilities and substance use have been found to be most beneficial when they are trauma-informed and women-centered (e.g., allowing children to accompany their mothers, involving peer support, providing women-only residential facilities) and we suggest prenatal health centers consider adopting these approaches as standard operating procedures [ 33 – 35 ].…”

Section: Discussionmentioning

confidence: 99%

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Gaps in the congenital syphilis prevention cascade: qualitative findings from Kern County, California

et al. 2022

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Background Congenital syphilis is preventable through timely access to prenatal care, syphilis screening and treatment of pregnant women diagnosed as infected. In 2018, California had the second highest number of congenital syphilis cases in the United States (U.S.), a nearly twofold increase in cases since 2014. This study assessed gaps in preventing congenital syphilis in the high morbidity region of Kern County, California. Methods Between May 2018 and January 2019, we conducted five focus group discussions with pregnant/postpartum women and ten semi-structured interviews with prenatal care providers in Kern County. Focus group and interview data were recorded, transcribed, and analyzed to identify emergent themes pertaining to facilitators and barriers at each step (prenatal care, syphilis screening and treatment) in the congenital syphilis prevention cascade. Results Gaps in congenital syphilis prevention discussed in focus group discussions with pregnant/postpartum women were related to limited prenatal care access, social-, economic-, and cultural-barriers, and substance use and co-occurring intimate partner/domestic violence. The gaps identified from interviews with prenatal care providers included social economic vulnerabilities of pregnant women and stigma and shame around the vulnerabilities, distrust in medical system, prenatal substance use, limited prenatal substance use disorder treatment facilities, and inadequate provider training on context-specific congenital syphilis management strategies. Gaps in partner notification, screening and treatment for syphilis were brought up by pregnant/postpartum women and prenatal care providers. Conclusions Congenital syphilis continues to increase in Kern County and throughout the U.S. In high syphilis morbidity areas, comprehensive and tailored public health approaches addressing setting-specific gaps in prenatal screening and treatment are needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gaps in the congenital syphilis prevention cascade: qualitative findings from Kern County, California

et al. 2022

View full text Add to dashboard Cite

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“…We advocate against punitive approaches with pregnant women who are using substances, as these have been associated with rising trends of CS in the region. [30] California is one of three states in the U.S.…”

Section: Discussionmentioning

confidence: 99%

“…Instead of criminalization, research strongly suggests women-centered approaches are more bene cial for both the mother and the baby. Interventions for pregnant women with SUD can be strengthened by input from both prenatal care providers and those from more of the criminal justice/social welfare space (e.g., CPS case managers, prosecutors) so long as mothers are provided opportunity to demonstrate their parental capacity and interest [30]. Comprehensive case management services for social vulnerabilities and substance use have been found to be most bene cial when they are trauma-informed and womencentered (e.g., allowing children to accompany their mothers, involving peer support, providing womenonly residential facilities) and we suggest prenatal health centers consider adopting these approaches as standard operating procedures [33][34][35].…”

Section: Discussionmentioning

confidence: 99%

Gaps in the Congenital Syphilis Prevention Cascade: Qualitative Findings from Kern County, California

Park

Yip

Harville

et al. 2021

Preprint

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Background. Congenital syphilis is preventable through timely access to prenatal care, syphilis screening and treatment of pregnant women diagnosed as infected. In 2018, California had the second highest number of congenital syphilis cases in the United States (U.S.), a nearly 2-fold increase in cases since 2014. This study assessed gaps in preventing congenital syphilis in the high morbidity region of Kern County, California. Methods. Between May 2018 and January 2019, we conducted five focus group discussions with pregnant/postpartum women and ten semi-structured interviews with prenatal care providers in Kern County. Focus group and interview data were recorded, transcribed, and analyzed to identify emergent themes pertaining to facilitators and barriers at each step (prenatal care, syphilis screening and treatment) in the congenital syphilis prevention cascade.Results. Gaps in congenital syphilis prevention discussed in focus group discussions with pregnant/postpartum women were related to limited prenatal care access, social-, economic-, and cultural-barriers, and substance use and co-occurring intimate partner/domestic violence. The gaps identified from interviews with prenatal care providers included social economic vulnerabilities of pregnant women and stigma and shame around the vulnerabilities, distrust in medical system, prenatal substance use, limited prenatal substance use disorder treatment facilities, and inadequate provider training on context-specific congenital syphilis management strategies. Gaps in partner notification, screening and treatment for syphilis were brought up by pregnant/postpartum women and prenatal care providers. Conclusions. Congenital syphilis continues to increase in Kern County and throughout the U.S. In high syphilis morbidity areas, comprehensive and tailored public health approaches addressing setting-specific gaps in prenatal screening and treatment are needed.

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“… Manderson and Warren 2016 ). Only recently has the concept of biosocial precarity been advanced to describe conditions that can cause health problems as well as stigma, social marginality, and legal problems, such as the use of illicit substances in pregnancy ( Premkumar et al 2020 ). However, the concept of precariousness seems less adequate to describe the social and moral disorientation that illness brings, even when it is not strongly linked to social marginality and economic difficulties.…”

mentioning

confidence: 99%

The Uncertain Presence: Experiences of Living with Metastatic Breast Cancer

Greco

2021

Medical Anthropology

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Drawing from interviews with women with metastatic breast cancer in the UK and France, in this article I analyze uncertainties linked to this condition. In particular, I show how the impossibility of foreseeing the evolution of the condition, also as an indirect consequence of medical innovation, initiates an irreparable disruption of life after diagnosis. I further show how the lives of the patients are not only limited by the illness, but also by the difficulty of finding a place in society. I argue that such experiences are best understood through the concept of the crisis of the presence.

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“A Résumé for the Baby”: Biosocial Precarity and Care of Substance-Using, Pregnant Women in San Francisco

Cited by 6 publications

References 52 publications

Gaps in the congenital syphilis prevention cascade: qualitative findings from Kern County, California

Gaps in the congenital syphilis prevention cascade: qualitative findings from Kern County, California

Gaps in the Congenital Syphilis Prevention Cascade: Qualitative Findings from Kern County, California

The Uncertain Presence: Experiences of Living with Metastatic Breast Cancer

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