Substance Use in Pregnancy: Identifying Stigma and Improving Care

Area of Science:

• Perinatal Health
• Addiction Medicine
• Social Determinants of Health

Background:

• Stigma against substance use is pervasive, framing addiction as a weakness.
• This stigma undermines self-efficacy, help-seeking, and belief in deserving care among pregnant individuals who use substances.
• Societal factors like gender roles and parenting fitness beliefs perpetuate punitive approaches over therapeutic ones.

Purpose of the Study:

• To examine the multifaceted impact of stigma on pregnant individuals with substance use disorders.
• To highlight the risks associated with stigmatizing attitudes, including child welfare involvement and loss of parental rights, particularly for women of color.
• To identify effective strategies for supporting recovery and treatment engagement in this population.

Main Methods:

• This review synthesizes existing literature on stigma, substance use, and pregnancy.
• Analysis of social factors contributing to stigmatization and punitive outcomes.
• Examination of current treatment modalities and engagement challenges.

Main Results:

• Most pregnant individuals reduce or cease substance use upon learning of their pregnancy, despite stigma.
• Pregnant individuals who use substances face increased risk of screening, child welfare referral, and parental rights termination.
• Treatment options exist but are underutilized; sustained engagement remains a challenge.

Conclusions:

• Combating stigma requires a trauma-informed approach incorporating harm reduction and motivational interviewing.
• Caregivers must focus on building trust, enhancing self-efficacy, and strengthening resources for the parent-baby dyad.
• Addressing stigma is essential for improving health outcomes for pregnant individuals and their infants.