Barriers and facilitators in antenatal settings to screening and referral of pregnant women who use alcohol or other drugs: A qualitative study of midwives’ experience

Oni, Helen Tosin; Buultjens, Melissa; Blandthorn, Julie; Davis, Deborah; Abdel-Latif, Mohamed E; Islam, M. Mofizul

doi:10.1016/j.midw.2019.102595

Cited by 38 publications

(33 citation statements)

References 47 publications

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“…Continuity of care helps to reinforce relationships between professionals and pregnant women and allows for the development of trust and disclosure of sensitive issues (Oni et al, 2020). The importance of building good relationships with pregnant women to inform decision making was stressed by professionals in this study (Ayerle et al, 2012; Critchley, 2020).…”

Section: Discussionmentioning

confidence: 99%

Social Worker and Midwife Decision Making Regarding Child Protection Risk and the Unborn Baby: A Qualitative Study

2021

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A newborn baby is vulnerable to abuse and neglect, and the professional role may involve assessment before the baby is born. The aim of this paper is to explore the perspectives and experiences of midwives and child protection social workers regarding the protection of unborn babies within Northern Ireland. Data were gathered using four focus groups (14 midwives and 16 child protection social workers) within one Health and Social Care Trust. The data were analysed in terms of understanding risk factors and forming a professional judgement. The mental wellbeing of the pregnant woman, drug use, alcohol use, domestic violence, the pregnant woman's childhood experiences, gestation period and antenatal care attendance were the main risks identified. Observations, engaging with the pregnant woman and using ‘soft intelligence’ were key aspects in forming a professional judgement. The appraisal of the ability of the pregnant woman to recognise danger was an important moderating factor, and perhaps formed part of a professional judgement heuristic to assist in making sense of wide‐ranging information about diverse risks. Key Practitioner Messages Identified risk factors included mental wellbeing, age, feelings about the pregnancy, drug and alcohol use, domestic violence, the pregnant woman's childhood experiences, gestation period and antenatal care attendance. Pregnant women were unable to recognise the dangers in misusing illegal or prescription drugs, excessive alcohol consumption and initiating/maintaining relationships with sex offenders. Key skills in forming a professional judgement involved engagement with the pregnant woman, professionals' experience and observations, and the use of ‘soft intelligence’.

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Section: Discussionmentioning

confidence: 99%

Social Worker and Midwife Decision Making Regarding Child Protection Risk and the Unborn Baby: A Qualitative Study

2021

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“…Qualitative research has also identified the lack of training among primary care providers as a barrier to engaging in conversations with pregnant women about their alcohol use (Wangberg et al, 2015;Chiodo et al, 2019;Taylor et al, 2007;Wouldes et al, 2009). Furthermore, healthcare providers may be deterred from screening for alcohol use based on the perceived lack of an available, validated screening tool and feelings of general discomfort in screening women (Oni et al, 2020). Improved training would be an important step to improve the PAE and FASD knowledge base and skills in screening among prenatal care providers including physicians, obstetricians, gynecologists, and midwives.…”

Section: Improving Detection and Prevention Of Paementioning

confidence: 99%

Screening for Alcohol Use in Pregnancy: a Review of Current Practices and Perspectives

Dozet

Burd

Popova

2021

Int J Ment Health Addiction

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Global trends of increasing alcohol consumption among women of childbearing age, social acceptability of women’s alcohol use, as well as recent changes in alcohol use patterns due to the COVID-19 pandemic may put many pregnancies at higher risk for prenatal alcohol exposure (PAE), which can cause fetal alcohol spectrum disorder (FASD). Therefore, screening of pregnant women for alcohol use has become more important than ever and should be a public health priority. This narrative review presents the state of the science on various existing prenatal alcohol use screening strategies, including the clinical utility of validated alcohol use screening instruments. It also discusses barriers for alcohol use screening in pregnancy, such as practitioner constraints, unplanned pregnancies, delayed access to prenatal care, and stigma associated with substance use in pregnancy, providing recommendations to address these barriers. By implementing consistent alcohol use screening, prenatal care providers have the opportunity to facilitate access to counseling and brief interventions and thus, to prevent new cases of FASD and improve maternal and child health.

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“…Additionally, many US midwives are experts in the group prenatal care model, which has been shown to be an effective modality for providing interprofessional care during pregnancy for women with substance use disorders as well as for providing interpersonal support from the group 14 . I suspect many midwives may feel unprepared for screening for substance use and next steps, like midwives in Australia, 15 but professional development opportunities are available, starting with excellent reviews in the Journal of Midwifery & Women's Health 16,17 . Although neonatal care is in the purview of pediatricians, midwives play an important role as patient advocates for patients to breastfeed and for the mother‐infant dyad to not be separated.…”

Section: Featured Reviewsmentioning

confidence: 99%

Current Resources for Evidence‐Based Practice, March/April 2021

Barger

2021

J Midwife Womens Health

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Barriers and facilitators in antenatal settings to screening and referral of pregnant women who use alcohol or other drugs: A qualitative study of midwives’ experience

Cited by 38 publications

References 47 publications

Social Worker and Midwife Decision Making Regarding Child Protection Risk and the Unborn Baby: A Qualitative Study

Social Worker and Midwife Decision Making Regarding Child Protection Risk and the Unborn Baby: A Qualitative Study

Screening for Alcohol Use in Pregnancy: a Review of Current Practices and Perspectives

Current Resources for Evidence‐Based Practice, March/April 2021

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