Substance Misuse in Pregnancy - NHS Lothian

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Substance Substance misuse misuse in in pregnancy pregnancy A resource pack for professionals in Lothian Written by Anne Whittaker Nurse Facilitator (HIV/Drugs), Primary Care Facilitator Team, Spittal Street Centre, 22 Spittal Street, Edinburgh, EH3 9DU. Published by NHS Lothian Deaconess House, 148 Pleasance, Edinburgh, EH8 9RS. Copyright © 2003
This pack has been approved by Lothian’s GP sub-committee. The web version of this document is on www.nhslothian.scot.nhs.uk Health care staff in Lothian can also access and download this document from the intranet. Acknowledgements Many professionals contributed to, supported and offered constructive suggestions and comments on the numerous drafts of this resource pack. The professional groups from Lothian who contributed to the pack include: midwives, maternity & neonate nurses, obstetricians & gynaecologists, neonatologists & paediatricians, health visitors, general practitioners, pharmacists, drug specialists, alcohol specialists, HIV specialists, public health staff, dental hospital staff, social work and voluntary sector staff. Anne would like to thank the following people: Pauline Connolly, Fiona McGuckin, Fiona McNeilage, Mary Simpson and all the Link Midwives for Substance Misuse, Chris Vinestock, Julia Holmes, Maria Wilson, Karla Napier, Agnes Moretta, Susan Stewart, Frances McGuire, Doreen Trainor, Dr Rhona Hughes, Dr Wang Liston, Dr Gerry Beattie, Dr Paula Midgley, Dr Jacqueline Mok, Dr Helen Hammond, Dr Karen Barclay, Jenny Carson, Sherry Wright, Alison Conlon, Dr Gordon Scott, Dr Fiona Watson, Dr Malcolm Bruce, Dr David Miles, Dr Catriona Morton, Dr Roy Robertson, Dr Muriel Simmonte, Jim Shanley, Jim Sherval, Dr Margaret Douglas, Graham Lyell, John Vevers, Jane Todd, Dr Judy Bury, Rosina Weightman, Dr Ewen Stewart, Dr David Ewart, Dr Jonathan Chick, Dr Claire McIntosh, Barbara McKenzie, Louise Learmonth, Karen Thorburn, Gail Trotter, Dee Mills, Jane Henry, Chris Cunningham, Ray deSouza, Geraldine Brown, Bertie Goffe, Brian Pringle, Claire Thomas, Liz Dahl and Dr Mary Hepburn. Anne would especially like to thank Patricia Drake who provided invaluable administrative and secretarial support. Finally, a special thanks to all the service users who contributed to the development of the service user information leaflets. Substance Misuse in Pregnancy 2
Page 1: Substance Substance misuse misuse i
Page 5 and 6: Page Drugs and their effects on the
Page 7 and 8: Appendices ........................
Page 9 and 10: Introduction Welcome to the ‘Subs
Page 11 and 12: Please note: 1. The terminology use
Page 13 and 14: Introduction Key points Setting the
Page 15 and 16: Pre-conceptual care � Agencies in
Page 17 and 18: Substance Misuse in Pregnancy 14
Page 19 and 20: Setting the scene The extent of the
Page 21 and 22: Organisational difficulties Profess
Page 23 and 24: • Financial problems (including d
Page 25 and 26: Introduction Key points Setting the
Page 27 and 28: The important role of partners need
Page 29 and 30: ecognises that a woman’s needs ar
Page 31 and 32: Guidelines on good practice This se
Page 33 and 34: An assessment of the partner’s dr
Page 35 and 36: Care management Some women with sub
Page 37 and 38: Introduction Information and guidel
Page 39 and 40: anxiety related problems and can in
Page 41 and 42: Substance Misuse in Pregnancy 34
Page 43 and 44: Drugs and their effects on the deve
Page 45 and 46: Effects of tobacco The significant
Page 47 and 48: Effects of drugs (illicit and presc
Page 49 and 50: • fetal death in-utero (miscarria
Page 51 and 52: Introduction Key points Setting Neo
Page 53 and 54:
• poor feeding ability (hungry bu
Page 55 and 56:
monitored. Any drug treatment admin
Page 57 and 58:
� Swaddling of the baby will help
Page 59 and 60:
Babies with severe symptoms usually
Page 61 and 62:
Management of substance use in preg
Page 63 and 64:
Scottish Executive advice recommend
Page 65 and 66:
If a ‘hazardous’ drinking score
Page 67 and 68:
Assessing drug related problems It
Page 69 and 70:
Substitute prescribing Lothian has
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drug use should be the first goal t
Page 73 and 74:
A final word: Over the years, much
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Introduction Key points Setting the
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Amenorrhoea does not necessarily me
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Pre-conceptual advice on drug use c
Page 81 and 82:
Antenatal care Receiving good quali
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the antenatal ward, labour ward, an
Page 85 and 86:
usually possible to be quite reassu
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can be more serious in women with s
Page 89 and 90:
Introduction Key Risk points assess
Page 91 and 92:
for the women and can make attendan
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These documents contain important i
Page 95 and 96:
Intrapartum care (labour and childb
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There may be placental insufficienc
Page 99 and 100:
states she is taking the baby home
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Page 103 and 104:
Women who are Hepatitis B positive
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Substance Misuse in Pregnancy 90
Page 107 and 108:
Postnatal care The care of a pregna
Page 109 and 110:
Relapse prevention support work can
Page 111 and 112:
Introduction Assessing and managing
Page 113 and 114:
A number of childcare problems have
Page 115 and 116:
� Report your concerns to the Chi
Page 117 and 118:
Finally, it is important to remembe
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Services List Services providing ma
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with a drug dependency who are on s
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Drug services in Lothian Most speci
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Local drug services � Locality Cl
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Alcohol services in Lothian Most sp
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Other services in Lothian A variety
Page 131 and 132:
Introduction Key points Setting Fur
Page 133 and 134:
� Royal College of Obstetricians
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General � Scottish Executive webs
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References Abel EL, (1998) ‘Fetal
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NICE (National Institute for Clinic
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Page 143 and 144:
Drug/Alcohol related problem: refer
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Page 147 and 148:
INDEX Alcohol, 37-38, 52-56, 84 scr
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Introduction Key Appendices points
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Page 153 and 154:
Blood Borne Viruses and Pregnancy H
Page 155 and 156:
Management of HIV positive pregnant
Page 157 and 158:
east fed after these are given. The
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It is good practice therefore to of
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Page 163 and 164:
Page 165 and 166:
Introduction Appendix 4: Model Care
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Introduction Appendix 5: Key Consen
Page 169 and 170:
Introduction Key points Setting App
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Appendix 9: Introduction Midwifery
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Alcohol use (tick average weekly co
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Community Baby developed NAS sympto
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Neonatal Abstinence Syndrome Assess
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Drug Drug use use in in pregnancy p
Page 185 and 186:
aby. If you want to come off, it is
Page 187 and 188:
Labour Labour and and childbirth ch
Page 189 and 190:
Midwifery Midwifery care care staff
Page 191 and 192:
Helpful Helpful numbers numbers My
Page 193 and 194:
Produced by NHS Lothian © 2003
Page 195 and 196:
This leaflet provides you with info
Page 197 and 198:
Parents are encouraged to keep a cl
Page 199:
Breastfeeding Breastfeeding and and
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