This new resource from the National Drug & Alcohol Research Centre, University of New South Wales, Australia, is designed for all primary health care professions who see women in a broad range of health care service settings during the course of their practice.
The best practices guide builds on the evidence for providing coordinated, supportive and comprehensive care to pregnant women who use substances by providing a model for reducing the harm from alcohol and substance for women and their babies. See page 12 of this guide for a clearly charted overview of how physicians and other health care practitioners can support withdrawal, do psycho-social and nutritional interventions, and address barriers to care for pregnant women.
The model acknowledges the interconnections that impact a woman’s use of substances during pregnancy – including domestic violence, mental health, smoking, and stigma – and provides a guide for identifying risk and next steps for further assessment, support and/or treatment. See page 9 for a view of how identification differs for women who are pregnant, planning a pregnancy, or not planning a pregnancy.
It also moves beyond normal referral and coordination practices by using a holistic assessment process and designating a case coordinator or clinical lead to ensure “assertive follow-up.” Assertive follow-up consists of: making sure women are supported during pregnancy and birth; keeping mothers and their babies in the hospital so that post-birth assessments for mother and child can be done and plans for support and services are in place; providing breastfeeding, safe sleeping, parenting skills and contraception support; as well as, interfacing with partners, family members, and community agencies in support of the woman and her child. See page 16 for more discussion on assertive follow-up and pages 19-20 for “Addressing barriers to care”.
Although the extensive resources that are included in this guide are geared for practitioners in Australia, many of them provide topic-specific information that practitioners everywhere may find helpful. See pages 24-27 for website links.
For more on screening in primary care settings, see previous posts:
- Planning and Implementing Screening and Brief Intervention for Risky Alcohol Use: A Step-by-Step Guide for Primary Care Practices from the CDC (August 4, 2014)
- “Women Want To Know” Campaign for Health Professionals from Australia (July 9, 2014)
- World Health Organization releases the first evidence-based global guidelines to prevent and treat substance use by pregnant women (April 18, 2014)
- Alcohol Screening, Brief Intervention and Referral: Helping Patients Reduce Alcohol-related Risks and Harms resource (December 17, 2012)
- “No Alcohol, No Risk” Film for Midwives (May 22, 2012)
- Women and alcohol resources from the American College of Obstetricians and Gynecologists (ACOG) (March 29, 2012)
- SOGC releases new clinical guidelines on alcohol use and pregnancy (August 12, 2010)
For more on FASD prevention in Australia, see previous posts:
- FASD Prevention in Australia (April 14, 2015)
- “Women Want To Know” Campaign for Health Professionals from Australia (July 9, 2014)
- Strong Spirit Strong Future campaign in Western Australia (December 19, 2013)
- Pregnant Pause Campaign for Aussie Dads(October 1, 2013)
- FASD Campaign from Kimberley and Pilbara regions of Western Australia (October 22, 2012)
- Grannies Group in South Australia addressing alcohol misuse (September 27, 2012)
- Understanding the links between FASD and early life trauma in indigenous communities in Australia (July 11, 2012)
- Alcohol Think Again Campaign in Western Australia (June 19, 2012)
- Films from the Lililwan Project: Tristan and Marulu (May 9, 2012)
- FASD Prevention in Australia’s Ord Valley (October 13, 2011)
- Yajilarra: the story of the women of Fitzroy Crossing (October 15, 2010)
Girls, Women, Alcohol, and Pregnancy 