Examining barriers to harm reduction and child welfare services for pregnant women and mothers who use substances using a stigma action framework

Dados Bibliográficos

ID14948246
AutoresLindsay Wolfson (0000-0002-4584-6494, Centre of Excellence for Women's Health Vancouver BC Canada, autor correspondente), Ruth A Schmidt (0000-0002-0307-8482, Centre of Excellence for Women's Health Vancouver BC Canada), Julie Stinson (0000-0001-6317-9464, Centre of Excellence for Women's Health Vancouver BC Canada), Nancy Poole (0000-0002-0932-2992, Centre of Excellence for Women's Health Vancouver BC Canada)
Ano2021
Volume29
Fascículo3
Páginas589-601
Data de publicação2021-05-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoHealth & Social Care in the Community (JOURNAL)
Identificadores do periódicoISSN: 0966-0410 • E-ISSN: 1365-2524
EditoraWiley (PUBLISHER • GB)
DOI10.1111/hsc.13335
PMID33713525
OpenAlexW3137132880
IdiomaEN
Citações recebidas41
Referências citadas73

Pregnant women and mothers who use substances often face significant barriers to accessing and engaging with substance use services. A scoping review was conducted in 2019 to understand how stigma impacts access to, retention in and outcomes of harm reduction and child welfare services for pregnant women and mothers who use substances. The forty-two (n = 42) articles were analysed using the Action Framework for Building an Inclusive Health System developed by Canada's Chief Public Health Officer to articulate the ways in which stigma and related health system barriers are experienced at the individual, interpersonal, institutional and population levels. Many articles highlighted barriers across multiple levels, 19 of which cited barriers at the individual level (i.e., fear and mistrust of child welfare services), 18 at the interpersonal level (i.e., familial and relational influence on accessing substance use treatment), 30 at the institutional level (i.e., high organisational expectations on women) and 17 at the population level (i.e., negative stereotypes and racism). Our findings highlight the interconnectedness of stigma and related barriers and the ways in which stigma at the institutional and population levels pervasively influence individual and interpersonal experiences of stigma. Despite a wealth of literature on barriers to treatment and support for pregnant women and mothers who use substances, there has been minimal focus on how systems can address these formidable barriers. This review highlights the ways in which the barriers are connected and identifies opportunities for service providers and policymakers to better support pregnant women and mothers who use substances

Environmental health · Harm · Harm reduction · Interpersonal communication · Population · Psychiatry · Public health · Homelessness and Social Issues · Maternal Mental Health During Pregnancy and Postpartum · Medicine · Nursing · Prenatal Substance Exposure Effects · Psychology · Social Psychology