Sheway's Services for Substance Using Pregnant and Parenting Women: Evaluating the Outcomes for Infants

Abstract

Sheway is a single-access comprehensive street-front service to pregnant and parenting women with a history of alcohol and/or drug abuse that is located in one of Canada's poorest neighbourhoods, the Downtown Eastside of Vancouver. This investigation assesses the concurrent health and social problems clients report upon entry into the program, service utilization, and the impact of services on neonate and infant well-being. Data were collected through the review of files from the 9 ½ years of the agency's service. Findings suggest that the clients' concurrent health and social problems have increased over the years of operation while indicators of infant health have either improved or maintained steady rates.

Effectiveness of Prenatal Screening for Substance Use: Critical Consciousness, A Promising Curriculum for Compassionate Screening

“…In Alberta, the reported prevalence of substance use by pregnant women was 30% for tobacco, 25% for alcohol, and 15% for illicit drugs [3,4]. The Sheway's evaluation in 1998 reported an annual population of 3,000 families with pregnant women and parenting mothers who used substance in the Downtown East Side of Vancouver [5,6,7]. The Universal prenatal screening for substance use (PSSU) has been promoted as a public health solution to reduce obstetric complications, developmental retardations, neonatal abstinence syndrome and increased mortality [4,[8][9][10].…”

The role of nurse practitioners in outreach services and facilitating access for marginalized adult women in British Columbia

“…Although the focus of this paper is on marginalized adult women in general, it is important to note that in this literature review there is an over representation of marginalized Aboriginal women (Butters & Erickson, 2003 ;Deering et al, 2011a;Janssen et al , 2009;Kurtz et al, 2008;Lazarus et al, 2012;Marshall, Charles, Hare, Ponzetti, & Stokl, 2005;Salmon et al , 2009). For example, Marshall et al (2005) found that, of the women using Sheway, the downtown eastside street-front service, 80.7% were Aboriginal.…”

“…Eight studies using data relating to British Columbia have been reviewed (Deering et al, 2011a;Janssen et al, 2009;Jozaghi & Andresen, 2013;Kurtz et al, 2008;Lazarus et al, 2012;Marshall et al, 2005;Salmon et al, 2009;Wardman, Clement, & Quantz, 2005). Four studies from Ontario were identified and included (Butters & Erickson, 2003;Daiski, 2005;Goodman, 2006;Woolhouse, Brown, & Lent, 2004).…”

“…Women are given enough autonomy in these settings to direct the services they receive without the pressure to abstain from drug use (Islam et al , 2012;Marshall et al, 2005). In this context, Program, indicates that a harm reduction approach is more important than an approach that would promote abstinence from drugs, particularly when it comes to attending to the health of street-based drug users.…”

“…Marshall et al (2005) note that this form of flexible service has proven to successfully increase access to primary health care in Vancouver's downtown eastside with the initiation of Sheway, a comprehensive street-front service for pregnant women and mothers with a history of alcohol and/or drug abuse. While the women's health problems have been shown to increase over the years, the indicators of infant health showed improvement or at least stability (Marshall, 2005). Supporting marginalized women, even though they remain active in their addiction, as well as promoting and encouraging their autonomy even if they do not always understand their best interests, can be challenging for health care providers.…”