Balancing Between Hope and Realism

Abstract

Pregnancy for women who use substances has sometimes been referred to as a "window of opportunity" for lifestyle change. In this article, the aim is to analyze professional accounts of the transition of substance-using pregnant women into parenthood. Focus groups were carried out with professionals working at specialized maternity care units in Sweden. The analysis is guided by the discursive psychological concept of "ideological dilemma" and focuses on contradictory elements of commonsensemaking in the participants' discussions. The results suggest that professionals articulate two, partly contradictory, ideals: on the one hand, "believing in the patient" and, on the other, "being realistic." In their descriptions of their work with patients, professionals emphasize the significance of adjusting the self-image of the patients and increasing their awareness of their "abuse" problems in order to prevent future clashes between high expectations and reality. At the same time, they also underline that interacting with and treating those patients with the most serious problems as individuals with unforeseen strengths and resources is a matter of professional duty.

Social Stigma and Perinatal Substance Use Services: Recognizing the Power of the Good Mother Ideal

“…Provider-focused studies highlight the strong concerns providers hold regarding child safety and their perceptions of mothers with an SEP as "risky" (Fraser et al, 2007;Maguire et al, 2012;Murphy-Oikonen et al, 2010;Shaw et al, 2016, Whittaker et al, 2019. When met with resistance from women with an SEP, healthcare providers have expressed difficulty in carrying out their professional obligations (Heimdahl, 2018). These tensions can impair healthcare and other service providers' ability to separate their emotions from decision-making in treatment to meet the needs of women with an SEP (Heimdahl, 2018;Miles et al, 2014).…”

“…When met with resistance from women with an SEP, healthcare providers have expressed difficulty in carrying out their professional obligations (Heimdahl, 2018). These tensions can impair healthcare and other service providers' ability to separate their emotions from decision-making in treatment to meet the needs of women with an SEP (Heimdahl, 2018;Miles et al, 2014). While many providers report empathy for mothers and understand the complexity of their situation, they still struggle with their own biases and judgmental thoughts (Benoit et al, 2014;Geraghty et al, 2019).…”

Relational parenthood in addiction recovery

“…In family treatment settings, parenthood is the focus of change and is thus constructed in relation to professionals who may have negative attitudes towards substance abusers. This may affect how treatment-seeking parents understand themselves and how they identify with their parental roles (Grunow & Evertsson, 2021; Heimdahl, 2018; Lind et al, 2017). In the research by Virokannas (2011), drug-abusing mothers experienced the role of welfare authorities mostly as adversaries and only seldom as a partnership, while in the study by Chou et al (2020) mothers found support from personnel important.…”

“…In families with parental substance abuse, the special needs of parents and children are often interconnected (Akin et al, 2015;Alexanderson & Näsman, 2017). Effective support for parenthood in addiction treatment and family-focused treatment can strengthen parenting skills and parents' emotional coping, which may help them in parenting and also lead to better outcomes for people abusing intoxicants (e.g., Dawe et al, 2021;Heimdahl, 2018;Neger & Prinz, 2015;Seay et al, 2017).…”