Title: Barriers to screening pregnant women for substance abuse Introduction: Drug and alcohol use in pregnancy poses a threat to the neonate’s development and the obstetric provider has an obligation to screen for substance use. Substance use in pregnancy can place the developing fetus at risk for in-utero opioid dependence, fetal-alcohol syndrome, preterm labor, and other consequences of maternal alcohol, tobacco, and illicit drug use.(6) Within the past three years La Crosse County has seen a marked increase in the amount of heroin use.(7) The American College of Obstetricians and Gynecologist (ACOG) has clearly documented how instrumental the Obstetrician can be in screening patients for alcohol, tobacco, and illicit drug use. (1,12) The standpoint of ACOG, is that drug screening should be implemented in a non-judgmental fashion which will not deter the woman from seeking prenatal care. (12) In doing so the Obstetrician can facilitate a healthy trustful relationship with their patient in which the patient feels safe to discuss their substance abuse and seek help without fear of litigation.(12) Many methods of screening have been implemented including neonatal sampling of hair and meconium, maternal urine screening, and maternal self-reports.(11) In considering wide-spread feasibility, self-report measures have been commonly used, some more known and validated methods include the 4 P’s plus and TWEAK. (4,5,13) In the clinic visit, the Obstetrician may also implement a brief motivational interview to assess the patients willingness to change. The Treatment and Intervention Protocol recommends the FRAMES Approach where the providers give feedback, responsibility, advice, menus of change options, empathy, and empowers t... ... middle of paper ... ...lin, and Kevin Grumbach. "Screening and Intervention for Intimate Partner Abuse Practices and Attitudes of Primary Care Physicians." The Journal of American Medical Association 282.5 (1999): 468-474. JAMA. Web. 25 Nov. 2013. 20. Gassman RA. Medical specialization, profession, and mediating beliefs that predict stated likelihood of alcohol screening and brief intervention: Targeting educational interventions. J Subst Abuse. 2003;24(3):141–156. 21. Miner KJ, Holtan N, Braddock M, Cooper H, Kloehn D. Barriers to screening and counseling pregnant women for alcohol use. Minn Med. 1996;79:43–47. 22. Davis, PM, TL Carr, and CB La. "Needs assessment and current practice of alcohol risk assessment of pregnant women and women of childbearing age by primary health care professionals.."Canadian Journal of Clinical Pharmacology 15.2 (2008): 214-222.Pubmed.gov. Web. 25 Nov. 2013.
According to Brady and Ashley “Pregnant women with substance abuse issues faced many internal barriers to treatment. These include shame and fear of being judged by care providers, fear of being reported to social services and losing custody of children and public assistance resources, and co-morbid conditions such as depression and anxiety.If pregnant drug abusers know they will be punished for their actions, they will be less likely to search for help. Causing even greater complications in the fetus’s condition, instead of the mother seeking help to solve her addiction problem.” Just try to put yourself in the shoes of one of these
NAS has turned into an epidemic espicially in the state of Tennessee a little more than 320 babies were born with NAS in 2013. Tennessee was the first state to start keeping track of the number of cases of NAS. NAS occurs when pregnant women take drugs such as heroin, codeine, oxycodone, methadone, or buprenorphine (“Babies are being born addicted to drugs”). This happens when the substances pass through the placenta that connects the baby to its mother. Then the baby becomes dependent on the drug like the mother. Hospitals began treating these cases with morphine, by administering a dosage of morphine every few hours as needed and reducing the dosage until the baby was better. During this process doctors need to keep a look out for the babies since the morphine can cause them to stop breathing. A baby born with NAS usually suffers from low birth weight and respiratory problems. Heroin and cocaine are some of the most common drugs being abused, and they both have short and long term effects other than withdrawal symptoms: Such as ph...
A mother who drinks while she is pregnant stands a high risk of harming their unborn child because the alcohol passes through her blood to her baby, and that can harm the development of the baby’s cells. This is most likely to harm the baby’s brain and spinal cord. Many of the common effects of a child suffering from fetal alcohol spectrum disorder (FASD) is: distinctive facial features, growth problems making them smaller than the average child, and learning and behavior problems.
During the late 1970’s a movement began with state prosecutors using child abuse, endangerment statues and charges of provisions of drugs to a minor to prosecute pregnant women who used illicit substances during their pregnancies. The prosecution of a pregnant heroine user in the State of California with a felony child endangerment charge was one of the first of such prosecutions in 1977 (Stone-Manista, 2009, pp.823-856). This was the catalyst for the often biased punishment of pregnant drug addicts under the scope of the law. It is this vein of prosecution that struck ...
... excluded potential risk factors for preterm birth including previous pregnancies and multiple births. Thus, these results should only be applied to the risk of alcohol consumption for primiparous mothers with singleton pregnancies. However, despite the lack of risks identified in this study, alcohol use during pregnancy has been linked to disabilities. According to the American Academy of Child and Adolescent Psychiatry (AACAP, 2011), its adverse effects include fetal alcohol syndrome, learning disabilities, social ineptness, depression, and anxiety. The AACAP strongly recommends against pregnant women consuming any form of alcohol at any level. Despite the data presented by Dale et al. (2016), the question of the other risks of alcohol consumption on the fetus was not explored and thus alcohol use during pregnancy should not be condoned solely based on this study.
Assessing patient’s knowledge of the negative effects of alcohol consumption during pregnancy is most important step of a nursing process. It will lay a foundation for developing a nursing diagnosis and setting up goals with the only one outcome in mind-a healthy baby. We know now that even small amount of alcohol can cause birth defects, and for that reason patients need to be educated and aware of the negative effects alcohol will have on their baby if they chose to drink during pregnancy.
Drug (alcohol, tobacco & cocaine) addiction is accepted by the medical community as a disease. The medical model explains that consuming drugs excessively is a symptom of this medical condition. However, those in power that adhere to a conservative ideology do not accept the medical model's explanation as to why pregnant women would continue to use drugs knowing the adverse affect this will have on the fetus. Historically punitive measures involving incarceration and subsequent removal o...
Alcohol (wine, beer, or liquor) is the leading known preventable cause of developmental and physical birth defects in the United States. When a woman drinks alcohol during pregnancy, she risks giving birth to a child who will pay the price, in mental and physical deficiencies, for his or her entire life. One study (Phyllis Trujillo Lewis, MA, Philip A. May, PhD, and Virginia C. Shipman, PhD, 2007) asserted that “Numerous studies on alcohol-related birth defects have concluded that maternal drinking, compounded by other risk factors, leads to fetal alcohol syndrome (FAS). FAS is a serious birth defect and the most common non-genetic cause of mental retardation” as said by (Hankin, 2002; Abel & Sokol,1986; O’Connor, Kogan, & Findlay, 2002; May & Gossage, in press). It is unknown how much maternal alcohol consumption results in FAS or other related disorders, or why some women who drink are at substantially higher risk of giving birth to a child with alcohol-related disabilities than others (Stratton, Howe, & Battaglia, 1996). However, researchers have identified several maternal risk factors differentially associated with FAS. These include advanced maternal age, number of pregnancies, previous births of a child with FAS, cohabitation with a male partner who drinks heavily, and low socioeconomic status (SES; May et al. 2004; 2008a; Viljoen et al., 2002). FAS is 100% preventable, which makes awareness and education the core preventative method for FAS. It is seen through Lewis, May & Shipman’s research that women who are less educated are less aware of the risks involved with drinking while pregnant.
When it comes to pregnancy, expectant mothers usually have a lot of questions and concerns. One such concern is alcohol consumption. Some people feel that it is okay while others are against the consumption. However those who drink take a huge risk that can result in what is referred to as Fetal Alcohol Spectrum Disorders (FASD). This umbrella term is used to describe the range of damage from alcohol exposure to a fetus. The characteristics, diagnosis, and the mother are all important factors to look at when trying to understand these birth defects.
Prenatal alcohol exposure has become a serious problem not only in our country, but also all around the world. It is affecting the future generations of this planet and their health. The public needs to be well informed on the effects of prenatal alcohol exposure and how to prevent it from happening. By doing this, it will save our people billions of dollars as a whole and will stop abnormalities in the people. FAS and FASD are malformations that don’t need to happen and can be prevented so easily. If only the people knew the severity of the consequences to their actions.
All drugs, legal or illegal, are considered to be harmful to the fetus and should be taken with caution and under the doctor’s direct orders only. Drugs can be anything as simple as a cigarette to a major substance like heroin and cocaine. Most mothers who do drugs during their pregnancy don’t think about the detrimental effects they could be causing to their baby. Any amount of these forbidden substances can leave an everlasting effect on the precious defenseless baby. Most women know that when you are pregnant your hormones vary greatly, but when a woman is pregnant it also ...
It is dangerous for a mother to take drugs during pregnancy because the baby can be born addicted, and start having withdrawals. The illegal substances that feeds a mother’s addiction, also feeds the baby’s (4). Due to this, the
The discussion session is very informative regarding to the resources available to substance-abused moms and pregnant women. It is thought provoking to know the statistics of drug and alcohol used during pregnancy. Growing up, I was taught not to abuse drug or alcohol for a simple reason, addiction. At some point, I heard from multiple people that substance-abused could tremendously affect us in some shape or form. Especially during pregnancy, the consequences of such behavior would put an innocent life at risk. Hence, I think it’s easily to blame on the mother for any unfortunate consequences experiences by the newborn. Yet rarely, many of us would pause for a second and ask “why”.
“I brought you into this world, and I can take you out!” A child has most likely heard that phrase at some point in their life. Although, it is not ethical or legal for a mother to “take her kid out of this world”, it does bring up a good point that it was through her body, that the child was born. One of the most important responsibilities in this world is a mother carrying a child in the womb. There are many divine processes that take place during gestation, but there are also many contributing factors from the mother that can affect the developing human. These factors may include what a woman ingests and exposes her embryo or fetus to. Sadly, alcohol use during pregnancy is an ongoing problem that can have detrimental affects on the fetus, including Fetal Alcohol Syndrome (FAS). Choosing to drink alcoholic beverages during pregnancy is a choice, a risky choice. Unfortunately some women don’t even know they are making a risky choice by consuming alcohol because it is in the early stages of pregnancy. It is common for a female to not find out they are pregnant until at least the fifth or sixth week after fertilization. In 2006, 49% of all pregnancies in the United States were reported unintended on a national survey.1 The highest rate of preventable birth defects and mental retardation is due to alcohol use.2 In this paper, I will further discuss FAS, the potential effects of binge drinking during the embryonic stage of gestation, and what actions need to be taken in order to reduce the incidences of alcohol related birth defects.
They found that "women who aborted a first pregnancy were five times more likely to report subsequent substance abuse than women who carried to term and they were four times more likely to report substance abuse compared to those who suffered a natural loss of their first pregnancy (i.e., due to miscarriage, ectopic pregnancy, or stillbirth)". Their findings support prior cited studies showing such a link.