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Sheway is well-known in Canada for its success in providing wrap-around services for pregnant and newly parenting women who are dealing with complex personal and social circumstances. It is trauma-informed, women-centred, culturally responsive and uses a harm reduction approach with a focus on connection with self and others. Women and their children can remain in the program up to 18 months post-partum. Last December, Lenora Marcellus, University of Victoria, and Sheway published findings to their study on how women make the transition from Sheway to living on their own – Supporting Families at Sheway and Beyond. Additionally, Dr. Marcellus has published a journal article:

Marcellus, L. (2017). A grounded theory of mothering in the early years for women recovering from substance use. Journal of Family Nursing. E-print ahead of press. 

In order to learn what elements of a positive transition could be identified and built upon, they followed 18 women for 3 years after leaving Sheway. These women faced multiple obstacles in this transition process with the overarching theme being “holding it together.” Their daily efforts are explored in these 3 ways:

Download Sheway Report

Restoring Self: gaining recovery and taking care of self, reconnecting with self and others, and rebuilding trust and credibility.

Centering Family: parenting their children, preserving a routine, dealing with partners, and handling custody issues.

Creating  Home: “chasing housing”, having to take whatever housing is available even if inadequate, and maintaining not only a physical space but a feeling of home for the family

While acknowledging the value for pregnancy and postpartum support as most often provided in maternity programs, their findings underscore that secure housing is a key component to a successful transition for women and their families. Yet, although housing is important to the overall health of women and their families, the choices they must make often result in a double bind. For example, women often are faced with choosing between affordable housing that is far from supports versus more expensive housing that is near supports. Some women must choose between staying in an unsafe relationship or losing housing. As well, some women must accept inadequate housing because of their substance use history, which serves to undermine their recovery and their maintaining custody of their children.

“Poor housing was identified by women as a potential trigger to relapse in their recovery.” – [1] p. 39

Complete findings are detailed within the report and recommendations are framed within the Levels of Prevention model developed by this prevention network.  Among the research team recommendations is to extend the time women can stay in the program in order to solidify recovery, supports and resources. As well, they stress that housing needs to be a core component of intensive, integrated maternity programs.


For more on these topics, see earlier posts:

HOLISTIC AND SPECIALIZED SUPPORT FOR PREGNANT WOMEN: LEVEL 3 PREVENTION, November 21, 2016
THE MOTHER-CHILD STUDY: EVALUATING TREATMENTS FOR SUBSTANCE-USING WOMEN, MARCH 18, 2015
SUPPORTING PREGNANT AND PARENTING WOMEN WHO USE SUBSTANCES: WHAT COMMUNITIES ARE DOING TO HELP, OCTOBER 1, 2012
HERWAY HOME ‘ONE-STOP ACCESS’ PROGRAM IN VICTORIA SET TO OPEN, MAY 20, 2012
“NEW CHOICES” FOR PREGNANT AND PARENTING WOMEN WITH ADDICTIONS, JANUARY 9, 2012
TORONTO CENTRE FOR SUBSTANCE USE IN PREGNANCY (T-CUP), DECEMBER 19, 2011
CLINICAL WEBCAST ON BREAKING THE CYCLE PROGRAM: SEPTEMBER 20, 2011, AUGUST 2, 2011

  1. Marcellus, L., Supporting families at Sheway and beyond: Self, recovery, family home. 2016, Sheway: Vancouver, BC.

 

Pages from HR and Preg Booklet_web

This 16-page booklet provides a short introduction to harm reduction approaches during pregnancy.

Harm Reduction refers to policies, programs and practices that aim to reduce the negative health, social and economic consequences that may ensue from the use of legal and illegal psychoactive drugs, without necessarily reducing drug use.

Harm reduction  can be an important approach to FASD prevention for women who struggle with addiction and related concerns and who are often at highest risk for having a child with FASD.

The booklet gives an overview of evidence-based harm reduction approaches during pregnancy and provides concrete examples from integrated maternity programs in Western Canada that work with women with substance use concerns.

Programs profiled include: Sheway in Vancouver, Maxxine Wright Place in Surrey, HerWay Home in Victoria, H.E.R. Pregnancy Program in Edmonton and Manito Ikwe Kagiikwe (The Mothering Project) in Winnipeg.

Other topics discussed include the role of housing, peer support, rooming-in, methadone and buprenorphine use during pregnancy, and outreach.

Download Harm Reduction and Pregnancy: Community-based Approaches to Prenatal Substance Use in Western Canada from the BC Centre of Excellence for Women’s Health website.

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Launched in 2006, the Canadian Best Practices portal is an initiative of the Public Health Agency of Canada. The Best Practice Interventions section of the Portal is a searchable list of chronic disease prevention and health promotion interventions which is intended to provide program planners and public health practitioners with easy and immediate access to successful public health programs, interventions and policies that have been evaluated and have the potential to be adapted and used.

The Agency has recently launched a new Maternal and Infant Health Best Practices topic page which is available online here. The new Maternal and Infant Health section features interventions which aim to improve the health of pregnant and post-partum mothers and their babies. Two programs featured on the portal, Sheway and Breaking the Cycle, work specifically with pregnant women and new mothers with substance use concerns.

Work is currently underway to identify maternal and infant health interventions specifically tailored to Aboriginal populations and to new Canadians. Other gap areas that have been identified are father involvement in pregnancy and the postpartum period and parenting of infants with special needs.

To learn more about Sheway, Breaking the Cycle and other similar Canadian programs that work with women with substance use concerns in the perinatal period, see previous posts:

Also, check out this short presentation (15 min) by Dana Clifford at the 5th International Conference on Fetal Alcohol Spectrum Disorder held in Vancouver, BC in February 2013. Dana reflects on her experiences as an addictions counsellor at Sheway for close to 20 years and how the program has evolved over time to meet the needs of pregnant women and new mothers struggling with alcohol and other drugs.

Overview: Four Levels of FASD Prevention

Information Sheet: What Men Can Do To Prevent FASD

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