Substance Misuse in Pregnancy - NHS Lothian

surveillance and restricted options for treatment and care (Klee, Jackson
& Lewis 2002). Negative societal views and professional attitudes coupled
with discriminatory practice have deterred women from seeking help.
They may appear to neglect their condition and that of their babies but in
reality it may be the service’s attitudes and approach that have excluded
them from care (Morrison 1999).
Research evidence
Lack of good data and research evidence on the effects of illicit drug use
on the fetus and baby has led to some confusion and exaggeration of risk.
Providing balanced and factual information to women so that they can
make informed choices in pregnancy has proved difficult and women
continue to receive inconsistent and contradictory advice.
Women’s fears
Not surprisingly, pregnant women who have substance misuse problems
frequently report a number of concerns (Scottish Executive 2003) including:
• Fear that child protection agencies will be contacted automatically
• Fear that her baby will be taken into care
• Fear and confusion over whether her drug use will cause fetal damage
• Fear that she will be blamed if anything goes wrong with her
pregnancy
• Fear of being thought of as un uncaring or ‘unfit’ mother if she doesn’t
manage to come off or reduce her drug use
• Feeling guilty and ‘to blame’ for her baby experiencing withdrawal
symptoms
Poor social circumstances
Drug and alcohol related problems are commonly associated with socioeconomic
deprivation and poor social circumstances. These include:
• Poor support from family and friends
• Poor support from a substance-misusing partner
• Drug related criminal activity and legal problems (e.g. outstanding
charges, impending court cases, community service order, probation,
prison history, drug treatment and testing orders)
• Violence (e.g. substance misuse-related or domestic abuse)
Substance Misuse in Pregnancy
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