Come up for you when you think of pregnancy and parenting What thoughts Come up for you if we add substance use to pregnancy and parenting Substance abuse during pregnancy The agonizing problem of prenatal substance ID: 588787
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Slide1
What thoughts….
Come up for you when you think of pregnancy andparenting?Slide2
What thoughts…
Come up for you if we add substance use topregnancy and parenting?Slide3
Substance abuse during pregnancy
“The agonizing problem of prenatal substance...”
(1)
“I want my doctor to know that I used cocaine and alcohol during my pregnancy. I want to know if my baby is okay. But, I’m scared of what her reaction might be if I tell her.”
- Felicia
Dailard C, Nash E. State responses to substance abuse among pregnant women.
The Guttmacher Report
. December 2000.Slide4
Why might mothers use drugs and/or alcohol when they are pregnant?
Not as easy as just choosing to quit
Don’t know they are pregnant
Trauma
Co-occurring Mental Health issues
Lack of understanding
There are not enough treatment options
Partners who use / Family culture of use
Societal acceptance of use, particularly alcoholSlide5
A pregnant woman using substances…
Is a woman with an addiction who got pregnant
Desperately wants a healthy baby
Consumed by guilt
Fearful of what will happen if she is honestSlide6
But a pregnancy is
An incentive to quitAdded stress which is compounded when living in poverty
A short time to change behavior, social life and relationshipsSlide7
Scope of the Problem - National
Among pregnant women aged 15-44:
10.8% reported current alcohol use
3.7% reported binge drinking
1.0% reported heavy drinking
About 1 in 6 pregnant women aged 15-44 had smoked cigarettes in the past month
.
* Results from the 2010
National Survey on Drug Use and Health:
Summary of National FindingsSlide8
Scope of the Problem - National
The rate of illicit drug use by pregnant women in the combined 2009-2010 years:
16.2% among women aged
15 to 17
7.4% among women aged
18-25
1.9% among pregnant women aged
26-44Slide9
50% of pregnancies are intended
However this means that 50% are unintended
This rises to 80% unintended pregnancies with
opiod
useSlide10
Scope of the Problem - Colorado
2006:
70,737 babies born to women aged 14-44
In
Utero
Exposure:
Alcohol
11.6%
8,205
Tobacco
17.3%
12,237
Prescription Medication (non-medical use)
6%
4,244
Illicit Drugs
4.3%
3,042Slide11
Impact of pre-natal substance abuse exposure
Preterm delivery
Low birth weight
Fetal Alcohol Syndrome
Fetal Alcohol Effects
Fetal death
Possible long-term neurobehavioral effects –sometimes not seen until school age
Sudden Infant Death Syndrome (SIDS)
Increased risk for sexually-transmitted diseasesSlide12
“There’s a lack of understanding as far as drug addiction goes. A lot of doctors think that if you know you’re pregnant, you can just stop. For drug addicts, it’s not quite that simple.
- HallieSlide13
5 points of intervention
Pre pregnancyPrenatal
Birth
Post Natal
Throughout ChildhoodSlide14
Why intervene
Most women don’t realize they are pregnant until 6 – 8 weeksMost women continue to drink/use substances until they are aware of the pregnancy
7.6% continue to drink/use substances even after they are aware of the pregnancy
Makes it easier to ask without judgment if a woman was not aware of pregnancy (and they cannot be prosecuted before the birth)
We have a relationship and an opportunity to make a difference in the life of a childSlide15
How To Talk With Women
Women are relationship-oriented
Mothers-to-be need to feel safe and respected
Be sincere and empathic
Be sensitive to the possibility of trauma
Relationship building:
Building trust through parent-centered strategiesSlide16
4 P’s Tool
Do you consider one of your Parents to be an addict or alcoholic?Does your Partner have a problem with Drugs or alcohol?
Have you had a problem with drugs or alcohol in the Past?
Have you ever used drugs or alcohol during this pregnancy?Slide17
Routine screening
SmokingDomestic ViolenceChild AbuseDepressionSlide18
Why don’t we ask?
“not a problem for my families”“women lie anyway”Don’t have time
Don’t know how
Don’t know where to refer for treatment
Concern about legal action
Concern about child welfare action
May lose the familySlide19
Why Women Don’t Seek Treatment
Confusion
Guilt
Fear
Lack of support
Lack of treatment resources
Transportation barriersSlide20
Child Protective Services
Do you have to report?
NO!
Not for substance use
in itself. Only when Children are impacted directly.Slide21
How To Talk With Women
How and when to engage?
What are the barriers?Slide22
Do we need additional practices, policies for PAT?Slide23
Resources
Support Line at Families First 877-695-7996 or 800-CHILDRENConsejos
Para
Familias
;
866-Las-Familias (527-3264
844-CO 4 KIDS (Colorado reporting line)
SBIRT cardsSmartChoicesSafeKids.orgLinkingCare.org
MothersConnection.comColorado Crisis and Support Line 1-844-493-TALK