Haga District, Gothenburg
Image credit: Jonathan Ziapour, via flickr

Multidisciplinary team approaches to supporting pregnant women who use substances seems to be an effective and promising strategy for caring for women and their children.

In 2006, the Department of Health Care in Gothenburg (the second largest city in Sweden) decided to develop a specialized multidisciplinary unit for pregnant women with alcohol and drug issues. The team of professionals at the Mödra- Barnhälsovårdsteamet i Haga (Maternal Child Health team in Haga) has expertise in maternal health, child health, social work and addiction treatment and includes midwives, a paediatric nurse, social worker/counsellor, paediatrician, psychiatrist, gynecologist, psychiatric nurse, and an operations manager.

Women are referred by prenatal health care centres, addictions programs, social services or through the criminal justice system. Women can also self-refer. Sweden’s health care system provides free-of-charge prenatal and paediatric services. Many women are referred through local midwives. One week after a positive pregnancy test, midwives conduct an interview with all pregnant women to assess any areas of concern. The interview includes an AUDIT screening. (The AUDIT, the Alcohol Use Disorders Identification Test, is a brief screening questionnaire developed by the World Health Organization that health care providers can use to determine if an individual’s alcohol use may be harmful). If a midwife has concerns, she can make a referral to the Haga team.

The goals of the program are to support women in stopping their substance use during pregnancy (and to remain abstinent following pregnancy) and to minimize harm to the fetus. During pregnancy, women see midwives weekly and most are tested for alcohol and drugs regularly. Team conferences determine individualised care and support for each woman and the follow-up for infants/women. Extensive collaboration with social services, psychiatry and the paediatric health care system is essential and long-term follow-up is often required.

Preliminary findings from a recent evaluation has found that most women remain substance-free during pregnancy and there have been no cases of FASD diagnosed since the program started in 2007. Many women are reporting the importance of feeling supported and not judged for their substance use as key for their success in the program.

Members of the Haga team, Antonia Reuter and Thomas Arvidsson, recently presented at the 2nd European Conference on FASD. View their abstract “Cross-disciplinary specialist care for substance abusing pregnant women and their infants in Gothenburg, Sweden, and what the women tell us about their experience of the care” here.

For other examples of specialized health care programs for pregnant women who use substances, see previous posts: