Feminist ethics must inform practice: interventions with perinatal substance users

Substance use during pregnancy is a major health and social issue in countries around the world. Even though many health professional associations recommend a voluntary health promotion approach to treatment, some professionals and legislators have pursued mandatory treatment, or protective intervention. A feminist ethic perspective of treatment invites us to consider a broader notion of autonomy, which includes the contexts in which women live, the difficulty they often have in accessing treatment services, and their endurance of systematic oppression related to ethnicity, socioeconomics, and politics. A punitive approach to treatment is not associated with improved outcomes for the fetus; in fact, the fetus may be at greater risk as women are fearful of accessing health services. Treatment is best pursued on a common ground basis within an embodied model of maternal-fetal relationship that will help support women and at the same time help ensure fetal health.