Substance Misuse in Pregnancy - NHS Lothian

Framework for care
A number of recent governmental publications have provided a broad set
of principles and guidelines on good practice for working with pregnant
women and families affected by drug and alcohol related problems. These
include:
� ‘Drug Misuse and Dependence – Guidelines on Clinical Management’,
Annex 5: ‘Pregnancy and Neonatal Care’, Department of Health (1999)
� ‘A Framework for Maternity Services in Scotland ‘, Scottish Executive
(2001)
� ‘Integrated Care for Drug Users’, Effective Interventions Unit (2002)
� ‘Plan for Action on Alcohol Problems’, Scottish Executive (2002)
� ‘Getting Our Priorities Right’, Scottish Executive (2003)
� ‘Hidden Harm: responding to the needs of children of problem drug
users’, The Advisory Council on the Misuse of Drugs report (2003)
Philosophy of approach
The philosophy of approach outlined here reflects the central themes
from these policy documents as well as recommendations from leading
experts in the field.
Overall, the approach to care needs to be:
� women and family centred
� non-judgemental
� pragmatic, with an emphasis on harm reduction
� holistic
� provided by a multi-disciplinary and multi-agency team
Women and family centred approach
Pregnancy and the transition into parenthood is a significant life event.
For women who have problems related to alcohol and drug misuse it offers
opportunities as well as risks. These women have the same hopes and
aspirations for family life and the same anxieties about pregnancy,
childbirth and motherhood as other women (Ford & Hepburn 1997). For
service providers, the challenge is to offer the right kind of support that
will allow them to minimise the risks as much as possible and to make the
most of available opportunities. This means that treatment and care needs
to be women and family centred.
Substance Misuse in Pregnancy
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