Midwives are well-positioned to help support pregnant women to stop or cut down on alcohol and other drug use and to improve outcomes for themselves and their children, according to researchers.
A new South Australian initiative is examining the role midwives can play in promoting key public health messages and supporting abstinence during pregnancy.
The program, which involves a collaboration between experts at Flinders University, the University of Adelaide and the Northern Adelaide Local Health Network (NALHN) is being funded by the Australian Government Department of Health and Aged Care.
In a new research protocol recently published in Addiction Science and Clinical Practice (BMC), researchers outline how they will investigate the pivotal role midwives play in engaging with pregnant women during regular hospital antenatal clinic checks and suggest improved systems for identifying and supporting the reduction of any alcohol and other drug use during pregnancy.
“Alcohol, tobacco and illicit drug use during pregnancy can cause significant harm to women and their developing babies,” says lead author of the study, Dr Matthew Stevens, from The University of Adelaide.
“Despite recommendations for abstinence during pregnancy, some women need additional advice and in some cases further support in order to discontinue use, making screening and early intervention an important strategy for reducing risk.”
NALHN and Flinders University Professor of Women’s Health and Midwifery Research, Dr Annette Briley, says the study aims to improve the rates of screening and intervention for substance use among pregnant women, including appropriate referral for those who may be substance-dependent.
“We have outlined a protocol which focuses on a multi-stage approach in implementation,” she says.
“With periods of abstinence promoted during pregnancy, this time presents an ideal opportunity to discuss lifestyle practices and seek help to make change to healthier lifestyle choices.”
According to researchers, health warnings from government agencies and advice from midwives about refraining from using alcohol, tobacco and illicit drug use during pregnancy are already a potential catalyst for healthier choices for the mother and her child.
The new project commenced amid changes in recent years of the availability and habits of alcohol, tobacco and other drug use, including the rise of vapes as a substitute for tobacco, they add.
“We’ve seen a large shift in the availability and attitudes towards both licit substances like alcohol and tobacco, and illicit substances like cannabis in recent years and we wanted to find out how midwives discussed these issues with the women booking for antenatal care,” adds Dr Stevens.
“Despite strong public health campaigns around cessation of alcohol and tobacco use in pregnancy, some women struggle to discontinue use. It may also be the case that some women are unlikely to disclose recreational drug use in pregnancy. Therefore, midwives are in an ideal position to help women make the change.”
Questions researchers will ask midwives include “are they aware of current trends and do they feel confident to discuss these issues with women and support them through pregnancy?”
So far, the research team has completed phase one – a retrospective case note review which helped to understand the current practices around screening and intervention within the services.
The team has also conducted a ‘Training Needs Analysis’ of the midwifery staff at those services to understand attitudes, beliefs and commitments to care for pregnant women who use alcohol and other drugs.
Researchers are now focusing on providing training around identifying and responding to alcohol and other drug use and assessing and monitoring changes over time.
