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Is perinatal substance abuse falling through the cracks?
J M Mitchell1, O Keenan1, A Fakhoury1
1University Maternity Hospital Limerick, Limerick, Ireland.
Insights
Healthcare professionals lack confidence in managing perinatal substance abuse (PSA). Increased training and support, like drug liaison midwives, are crucial to improve care and reduce stigma for these high-risk pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Care
- Public Health
Background:
- Perinatal substance abuse (PSA) poses significant risks, including prematurity, low birth weight, and neonatal abstinence syndrome.
- Effective care pathways and optimized staff/patient education are essential for managing high-risk pregnancies affected by PSA.
- Understanding healthcare professionals' (HCPs) knowledge and attitudes is key to enhancing care and reducing stigma associated with PSA.
Purpose of the Study:
- To explore the knowledge and attitudes of healthcare professionals regarding perinatal substance abuse (PSA).
- To identify specific knowledge gaps among HCPs in managing PSA.
- To inform strategies for improving care and reducing stigma for pregnant individuals with PSA.
Main Methods:
- A cross-sectional study was conducted.
- Questionnaires were administered to 172 healthcare professionals (HCPs) in a tertiary maternity unit.
- Data collected focused on confidence, knowledge of referral pathways, and attitudes towards PSA.
Main Results:
- A majority of HCPs lacked confidence in both antenatal (75.6%) and postnatal (67.5%) management of PSA.
- Over half of HCPs (53.5%) were unaware of the correct referral pathway, and 32% did not know when to make a TUSLA referral.
- Most HCPs (96.5%) desired further training, and 94.8% supported the introduction of a drug liaison midwife.
Conclusions:
- Significant knowledge gaps and lack of confidence exist among HCPs regarding PSA management.
- There is an urgent need for enhanced staff training, drug liaison midwives, and dedicated clinics to address PSA.
- Implementing these measures is critical for improving care quality and reducing stigma for individuals and families affected by PSA.
Objectives:
Perinatal substance abuse (PSA) is associated with increased risk of prematurity, low birth weight, neonatal abstinence syndrome, behavioral issues and learning difficulties. It is imperative that robust care pathways are in place for these high-risk pregnancies and that staff and patient education are optimized. The present study explores the knowledge and attitudes of healthcare professionals toward PSA to identify knowledge gaps to enhance care and reduce stigma.
Methods:
This is a cross-sectional study using questionnaires to survey healthcare professionals (HCPs) working in a tertiary maternity unit (n = 172).
Results:
The majority of HCPs were not confident in the antenatal management (75.6%, n = 130) or postnatal management (67.5%, n = 116) of PSA. More than half of HCPs surveyed (53.5%, n = 92) did not know the referral pathway and 32% (n = 55) did not know when to make a TUSLA referral. The vast majority (96.5%, n = 166) felt that they would benefit from further training, and 94.8% (n = 163) agreed or strongly agreed that the unit would benefit from a drug liaison midwife. Among study participants, 54.1% (n = 93) agreed or strongly agreed that PSA should be considered a form of child abuse and 58.7% (n = 101) believe that the mother is responsible for damage done to her child.
Conclusions:
Our study highlights the urgent need for increased training on PSA to enhance care and reduce stigma. It is imperative that staff training, drug liaison midwives and dedicated clinics are introduced to hospitals as a matter of high priority.
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