Improving pregnancy outcomes: mothers and substance misuse

Abstract

The data for this retrospective quantitative audit was collected from 1999–2006 from a caseload of 324 pregnancies in Fife and was informed by a literature search undertaken while studying for a Post-Graduate Certificate in Addictions. The aim of the study was to determine whether enhanced midwifery support within a multi-disciplinary team affected pregnancy outcomes in drug and alcohol using women. Ethical approval was not required. Partnership working improved and women were offered intensive support from specialist midwives, addictions nurses and social services from pregnancy booking until at least 12 weeks postnatal. This article explores pregnancy outcomes for this client group in regard to substance misuse, gestation at delivery, BBV infection, criminality, employment, housing and criminal behaviour and breastfeeding rates, neonatal abstinence and birth weight in neonates in a geographical area of significant social deprivation.

Pregnant heroin addict: what about the baby?

“…Given that the rates of NAS among those on methadone are as high as 90%, it is perhaps surprising that our patient’s child did not have NAS. But evidence suggests that specialised multidisciplinary management of drug use during pregnancy can reduce the risk of NAS to as low as 26% 10. In fact, a good outcome for the mother and baby in this case is perhaps not all that surprising: better antenatal care, healthier pregnancies and healthier babies were outcomes reported in outpatient methadone programmes for pregnant women 11…”

Buprenorphine for the Treatment of Perinatal Opioid Dependence: Pharmacology and Implications for Antepartum, Intrapartum, and Postpartum Care

“…Women struggling with opioid dependence during pregnancy are at high risk both socially and obstetrically. A woman's motivation is generally high because of pregnancy, and her chance for achieving a sustained recovery is increased if she receives appropriate support 40,50,51 . However, a holistic, women‐centered approach is essential.…”

“…Midwifery care should be delivered in collaboration with a consulting obstetrician or family practice physician, an addiction medicine specialist, a substance abuse counselor, and possibly a psychiatric provider. Because midwives are trained to provide care for women in the context of family and community, they are well‐prepared to coordinate a comprehensive treatment approach addressing both obstetrical and social needs 29,50,51 …”

Substance Misuse During Pregnancy: Its Effects and Treatment

“…75 Human immunodeficiency virus (HIV) positive status is the only contra-indication to breast feeding in developed countries. The physical action of breastfeeding minimises the separation of mother and baby which in turn promotes bonding and attachment.…”