Diagnosing uncertainty, producing neonatal abstinence syndrome

Area of Science:

• Public Health
• Sociology
• Neonatal Care

Background:

• Substance use during pregnancy presents a significant public health challenge.
• Neonatal Abstinence Syndrome (NAS) is a key manifestation and response to this issue.
• Existing approaches to NAS are marked by uncertainty for families and practitioners.

Purpose of the Study:

• To explore the uncertainties surrounding the anticipation, identification, and response to NAS.
• To propose a framework for understanding and managing NAS that mitigates parental marginalization.
• To advocate for relationship-based care models in managing NAS.

Main Methods:

• Qualitative study involving interviews with 16 parents of infants at risk of NAS.
• Multidisciplinary focus groups with 27 health and social care professionals in Scotland, UK.
• Analysis drawing on social diagnosis and political ontology concepts.

Main Results:

• Parents and professionals experience considerable uncertainty in managing NAS.
• UK parents using opioids face risks of child custody loss, surveillance, and marginalization.
• Current NAS management can exacerbate parental marginalization.

Conclusions:

• Viewing NAS as a social diagnosis can inform more equitable clinical and social responses.
• Relationship-based care can empower service users and providers to challenge existing practices.
• Adopting a social diagnosis framework and relationship-based care can reduce marginalization of parents using drugs.