Parallel journeys: Exploring the lived experience of pregnant women with alcohol/substance use problems in Scotland

The impact of prenatal alcohol and/or substance use on fetal development is well established. While past research has sought to better understand the experiences of individuals affected by such fetal exposures, less is known about the experiences of pregnant women themselves. The current study therefore aimed to examine their lived experiences of accessing services, perceptions of risk, stigma, and how women make sense of this journey as they transition into motherhood.

Semi-structured interviews were conducted with six pregnant women, engaged with a specialist substance misuse midwifery service in Scotland. Data were analyzed using Interpretive Phenomenological Analysis (IPA), finding three super-ordinate themes and associated subthemes.

Participants discussed complex life histories, including trauma, domestic violence, and mental health challenges. Cultural norms surrounding alcohol and substance use were highlighted as complicating recovery and, for some, exacerbated prenatal substance use. Pregnancy was however considered a turning point; a circumstance that enabled sustained engagement with services and provided motivation for initiating recovery. For those continuing to use, their experiences were often characterised by feelings of guilt, worry, and disappointment. All participants described experiencing stigma and judgement, which in turn increased mistrust and created barriers to recovery, accessing care, and recovery.

Findings underpin the importance of non-judgmental and trusting relationships with professionals in promoting service engagement. Recommendations include integrating care models and improving access to recovery resources tailored for the pregnancy period. Addressing societal stigma remains critical to improve the outcomes for pregnant women with substance use dependencies.