Susan Boyd, PhDSamantha Hardeman, RN BScNBrittney Willetts, BA, BSW, RSWMay 22, 2013 AHRC Confrence
 Inner city drug using population often experiencehigh rates of stigma and discrimination Add in pregnancy and things be...
 Pregnancy will make it even harder to discusssubstance use Study cigarettes vs. Illicit drug use Pregnant women will n...
“Addict”“Addicted babies”“Prostitute”Substance “use” vs. “abuse”“Prostitute”“Crack Babies”“Hookers”“Heads”“Bum”May 22, 201...
May 22, 2013 AHRC Confrence
 Opiates = no negative developmentaleffects on fetus Used in early labor as pain controlmethod When a pregnant woman is...
 Minimizes withdrawls bymaintaining steady doseof opiates Once an adequate dose isestablished... DON’T decrease dosage....
 Positive step Some workers do not fully understand thebenefits of maintenance programs Some believe still active in he...
 No one knows how much alcohol and when inthe pregnancy it will cause developmentalissues Frequently new “reports” with ...
May 22, 2013 AHRC Confrence
 Neonatal Abstinence Syndrome (NAS) Policy: Baby separated from mom and sent to NICU ornursery for monitoring Best prac...
 If a pregnant woman has other kids in care, she mayhave difficulties accessing neonatal funds she isentitled to with cur...
Legislation states that a baby is not considered to be a life until it is bornPros Women are not being sentto jail for ch...
“Increasing the number of pregnant womenwho use drugs who receive prenatal carerequires systems-level rather than onlyindi...
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Street involved pregnant women part 2

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Street involved pregnant women part 2

  1. 1. Susan Boyd, PhDSamantha Hardeman, RN BScNBrittney Willetts, BA, BSW, RSWMay 22, 2013 AHRC Confrence
  2. 2.  Inner city drug using population often experiencehigh rates of stigma and discrimination Add in pregnancy and things become exponentiallymore complex People’s focus tends to stray towards the fetus andon what the “horrible” woman is “doing to it” People forget that addictions andmental health don’t just go awaywhen a woman becomes pregnantMay 22, 2013 AHRC Confrence
  3. 3.  Pregnancy will make it even harder to discusssubstance use Study cigarettes vs. Illicit drug use Pregnant women will need a lot more sensitivityfrom workers because they will assume theworker will judge them and very often feel guiltwithin themselves This will prevent pregnantsubstance using women fromaccessing services Supports need to be intensifiedinstead of being taken awayMay 22, 2013 AHRC Confrence
  4. 4. “Addict”“Addicted babies”“Prostitute”Substance “use” vs. “abuse”“Prostitute”“Crack Babies”“Hookers”“Heads”“Bum”May 22, 2013 AHRC Confrence
  5. 5. May 22, 2013 AHRC Confrence
  6. 6.  Opiates = no negative developmentaleffects on fetus Used in early labor as pain controlmethod When a pregnant woman is physicallydependant, withdrawl effects on momcan have a negative impact on the fetus Increased BP= less blood flow to baby,stress response, hormonal fluctuations,etc. Less withdrawing is safer for babyMay 22, 2013 AHRC Confrence
  7. 7.  Minimizes withdrawls bymaintaining steady doseof opiates Once an adequate dose isestablished... DON’T decrease dosage. The drug dependant baby (NOT addicted)will still withdraw when born. This ismanageable (non-medically andmedically) and does NOT lead to longterm complicationsMay 22, 2013 AHRC Confrence
  8. 8.  Positive step Some workers do not fully understand thebenefits of maintenance programs Some believe still active in her addictionand labelled as unable to care for baby The mom may want to wheen off to “lookbetter”May 22, 2013 AHRC Confrence
  9. 9.  No one knows how much alcohol and when inthe pregnancy it will cause developmentalissues Frequently new “reports” with conflictingresearch frequently Might be more socially acceptable to have adrink than a point or a hoot Mom with FASD: Doesn’t mean she can’tparent, just means she will need morestructure and supports. Need specialattention and supports given to themspecifically.May 22, 2013 AHRC Confrence
  10. 10. May 22, 2013 AHRC Confrence
  11. 11.  Neonatal Abstinence Syndrome (NAS) Policy: Baby separated from mom and sent to NICU ornursery for monitoring Best practice is to have baby room in with mom,kangaroo care, breastfeeding Fir Square Baby drug testing Very subjective on who to screen In our experience and in the literature non-Caucasianwomen are more likely to be screened Calling the social worker Health care workers tend to focus on the physical andnegate the social determinants of health Not enough time, not enough staffMay 22, 2013 AHRC Confrence
  12. 12.  If a pregnant woman has other kids in care, she mayhave difficulties accessing neonatal funds she isentitled to with current pregnancy Not eligible until third trimester for income supports Need a letter from doctor with due date to provegestation. In order to get it you need regular prenatalcare (ultrasound and Dr visit) Individuals are often turned away from IncomeSupports and confused as to why. Usually a smootherprocess when staff are present Individuals may not know policies resulting in a lesserability to advocate for themselves If an individual is turned away once, they aretypically reluctant to go backMay 22, 2013 AHRC Confrence
  13. 13. Legislation states that a baby is not considered to be a life until it is bornPros Women are not being sentto jail for child abuse Women can go onMethadone or Bup withouthaving the law involved Can disclose drug use toDoctor without having thelaw involved CS cannot becomeinvolved until baby is born– gives her the time to setthings up, detox, etc.Cons: No supports offered before babyis born People avoid going to children’sservices when its a minorconcern. Takes a lot ofadvocating, and children’sservices being receptive to theidea of change. Less opportunity to build apositive relationship with CS Most CS offices are more proneto apprehending before assistingto put supports in placeMay 22, 2013 AHRC Confrence
  14. 14. “Increasing the number of pregnant womenwho use drugs who receive prenatal carerequires systems-level rather than onlyindividual-level changes. These changesrequire a paradigm shift to viewing drug usein context of the person and society andacceptance of responsibility for unintendedconsequences of public health bureaucraticprocedures and messages about effects ofdrug use during pregnancy.” Roberts, S. C. M., & Pies, C. (March 2010). ComplexCalculations: How drug use during pregnancy becomes abarrier to prenatal care. Maternal Child Health Journal, 15,333-341.May 22, 2013 AHRC Confrence

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