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Dismantling Barriers to Treatment for Pregnant Women

Dismantling Barriers to Treatment for Pregnant Women

Substance use disorder (SUD) impacts a wide variety of people regardless of demographic factors like gender and socioeconomic status. However, some groups are at a greater risk for SUD during different periods of life. As noted in “Substance Use in Pregnancy” by Mary K. Prince et al., in the United States, 40% of people with a lifetime drug use disorder are women. In addition, 26% of individuals with a polysubstance combination of alcohol and drug misuse are women. Moreover, women are at their greatest risk for SUD during their reproductive years, highlighting additional barriers to treatment for pregnant women.

At New Creation Recovery, we recognize the need for gender-specific addiction treatment to address the specific needs of women. Addiction itself can be deeply disruptive to your daily life, relationships, goals, and well-being. However, the presence of polysubstance use for drug abuse and alcohol abuse coupled with pregnancy further complicates treatment for women. Having a multitude of gender-specific experiences and challenges presents barriers to treatment that are unique to women. Therefore, we are committed to providing gender-responsive Christian rehab that supports alcohol treatment. If you are looking for drug rehab near me, with our tailored women-only treatment, you can build a care plan that supports your specific experiences and needs for healing.

Yet, you may still have questions about the relationship between SUD and pregnancy. Why is SUD prevalent during pregnancy? How does pregnancy add another layer of barriers to treatment for women with SUD? Increasing your awareness of the risk factors for SUD during pregnancy provides insight into the barriers to treatment women experience.

Risk Factors for Substance Use Disorder During Pregnancy

It is important to note that pregnancy itself is not a catalyst for the development of SUD. Rather, as noted in the aforementioned publication, women do not typically choose to start using substances once they become pregnant. Women misusing substances during pregnancy are more likely to have had SUD before pregnancy. Moreover, most women with substance misuse challenges decrease their use of substances once they are aware of their pregnancy. Thus, the factors that contribute to SUD during pregnancy must consider the specific experiences and challenges women face. 

Looking at common substances used during pregnancy and polysubstance use can provide insight into the unique risk factors women face. Pregnant women most frequently use tobacco, alcohol, marijuana, cocaine, and opioids. Moreover, as stated by the Centers for Disease Control and Prevention (CDC), polysubstance use is common during pregnancy due to several risk factors. 

The CDC notes about 10% of pregnant women misuse alcohol, 74% of marijuana users also smoke, and 40% misuse alcohol and other substances. Moreover, the presence of SUD and polysubstance use in pregnant women can be related to sex and gender differences. Individual susceptibility to misuse and SUD for people in general includes genetic, environmental, psychological, biological, and socioeconomic factors. 

However, women experience additional risk factors related to:

  • Ease of access to alcohol and tobacco as legal substances
  • More likely to be prescribed opioids for gender-related pain 
  • Greater exposure to environmental stressors and trauma like childhood abuse and neglect and intimate partner violence (IPV)

Moreover, as noted in the Journal of Opioid Management, women face unique sociodemographic factors and mental health characteristics. Gender-specific sociodemographic factors and mental health characteristics must be addressed to understand SUD during pregnancy and barriers to treatment. Listed below are some of the other risk factors pregnant and childbearing-age women experience:

  • Women are more likely to be prescribed opioids during labor and delivery
  • There is a higher prevalence of co-occurring anxiety and depression
    • Depression and anxiety are highly prevalent with self-medicating with substances like alcohol
  • Women are more likely to have life experiences that contribute to depression
    • Depression during and after pregnancy

Thus, understanding the risk factors and the prevalence of SUD in pregnancy is important for awareness. With greater awareness, you can address the consequences of SUD on the well-being of women and children.

Impact of SUD on Well-Being in Pregnancy

According to MedlinePlus, engaging in prenatal care, eating nutritious foods, and staying active are important for a woman and her child’s well-being. However, substance misuse and SUD can negate healthy choices and increase harm from parent and child. Further, different substances can contribute to other health risks for unborn babies, infants, and developing children. Listed below are some of the ways substance misuse and SUD can harm children:

  • Alcohol
    • Fetal alcohol spectrum disorder (FASD): Lifelong condition that causes physical, behavioral, and learning difficulties
    • Growth and development difficulties during pregnancy
    • Risk of miscarriage and stillbirth
    • Lifelong difficulties with motor coordination, emotional control, socialization, education, and employment
  • Tobacco
    • Sudden infant death syndrome (SIDS)
    • Damage to a baby’s brain and lungs
    • Risk for miscarriage, stillbirth, premature birth, low birth weight, and mouth and lip birth defects
    • Increased risk of health issues like asthma, obesity, learning difficulties, and behavioral problems
  • Cannabis (marijuana)
    • Increased risk for developmental challenges like attention, memory, learning, and problem-solving in children and teens
    • Risk for miscarriage, stillbirth, premature birth, low birth weight, low length growth
    • Marijuana use during breastfeeding can harm brain development
  • Prescription and over-the-counter (OTC) drug use
    • There is little to no information on how prescription and OTC impact babies during pregnancy and breastfeeding 
    • Lack of information on the impact of anti-anxiety and antidepressant medications during breastfeeding
    • Polysubstance use of substances like tobacco, prescription opioids, and antidepressant medications increases the risk for neonatal abstinence syndrome (NAS)
    • Sudden disuse of medications including SUD medications can increase risks like withdrawal for mothers and babies
  • Opioids
    • Risk for miscarriage, stillbirth, premature birth, low fetal growth, birth defects, and NAS
    • Neonatal opioid withdrawal syndrome (NOWS)
  • Illegal drug use
    • Misuse of substances like cocaine, methamphetamines, and club drugs increases the risk of miscarriage, low birth weight, and birth defects
    • Increased risk of learning and developmental disabilities in children
    • Injecting substances increases your risk for HIV, which can be passed to your unborn child
    • Cocaine use is associated with polysubstance use, poor nutrition, and lack of prenatal care
      • Maternal migraines and seizures
      • Premature membrane rupture
      • Placental abruption
      • High blood pressure 
      • Preterm labor and difficult delivery
      • Miscarriage, low birth weight, low length growth, and smaller head circumferences
    • Methamphetamine use increases parental risk for preeclampsia, premature delivery, and placental abruption
      • Babies are at risk for low birth weight and length growth
      • Increased difficulties with emotional reactivity, anxiety, and depression in children
      • Children are more likely to be withdrawn and experience attention and cognitive challenges

Looking at the risk factors for substance misuse and SUD during pregnancy and nursing highlights the need for specialized treatment. Yet, women (in general), pregnant women, and mothers do not always receive adequate care for SUD or co-occurring conditions. Therefore, understanding barriers to treatment for women can support better health outcomes. 

Gender Barriers to Treatment: The Impact of Gendered Stigma

There are a wide variety of barriers to treatment women experience. However, gender-based stigma is one of the main barriers to treatment for women. Moreover, stigma is particularly prevalent and difficult for pregnant women and mothers. As noted in “Addressing Stigma Within the Dissemination of Research Products to Improve Quality of Care for Pregnant and Parenting People” by Megan Lipsett et al., only 9% of pregnant and parenting people with SUD seek treatment. 

Despite the prevalence of SUD among pregnant and parenting people, few seek care due to barriers to treatment like stigma. Yet, what exactly is stigma and how does it act as one of the major barriers to treatment for pregnant women with SUD? According to Substance Abuse and Rehabilitation, stigma is a dynamic process that encompasses individuals and structures continuously engaged in the exchange of power, control, and domination. Thus, stigma plays a significant role in how people are treated on an individual, intrapersonal, and institutional level. 

Further, levels of care can change based on the condition or construct in which stigma is applied. Yet, the stigma of many conditions and constructs are often interconnected like race and ethnicity, gender, and socioeconomic stigma. Regarding SUD stigma, it is often framed as a personal choice, weak moral character, and poor willpower. Moreover, SUD stigma can be broken into three major sections: internalized, interpersonal, and institutional stigma.

  • Internalized stigma: The cognitive or emotional absorption of negative messages or stereotypes about substance use that you believe and apply to yourself
    • Increases anxiety, depression, isolation, loss of self-love, and disengagement from your support system
  • Interpersonal stigma: The mechanism in which stigma is reenacted or manifested in your interactions with others
    • Experienced and perceived feelings of judgment and shaming from others
  • Institutional stigma: The process in which organizations, communities, or public policies have negative attitudes, beliefs, and policies that negatively affect how a condition or person is treated in an establishment
    • Visible and invisible SUD stigma can be found in:
      • Laws
      • Child welfare service policies
      • Allotment of social services
      • Underinvestment in treatment infrastructure
      • Discrimination in societal support systems: insurance benefits, employment, and housing

For pregnant women, in particular, SUD stigma is compounded by stigma related to gender and pregnancy. Pregnant people are more likely to experience compounding social, structural, and self-stigmatization related to cultural norms and societal expectations about women and their role in society. Listed below are some of the levels of stigma pregnant women experience:

  • Individual: You perceive yourself as a bad person for misusing legal and or illicit substances
    • Feelings of shame and guilt lead you to delay seeking prenatal care
  • Interpersonal: Your substance use leads to the loss of previously supportive partners, family, and friends, whether they use substances or not
    • Increases risk of isolation, depression, and overdose
  • Organizational: You encounter barriers to treatment for pregnancy and SUD due to discrimination from healthcare providers
    • A healthcare institute takes a urine sample to screen for drug use without your consent, they involve child welfare services, and they offer no SUD treatment support
      • You lose trust in your healthcare provider and withdraw from seeking perinatal care
      • The opportunity for SUD treatment is lost
  • Community: You encounter barriers to treatment for SUD due to discrimination for your status as a pregnant person
    • A substance use treatment center states that they cannot admit you into their program because you are pregnant
    • The treatment center does not offer you evidence-based medications to treat your SUD
  • Public Policy: You experience barriers to treatment for SUD due to the criminalization of substance use and the involvement of child welfare services
    • Pregnant and parenting individuals with SUD are less likely to engage in medical care
      • Increases the morbidity and mortality of substance use for parents and children

Looking at the examples of stigma’s impact on pregnant individuals highlights the harm of stigma. Being assigned roles as mothers, wives, and caregivers leads to harsher judgment, discrimination, bias, and marginalization for SUD during pregnancy. Moreover, pregnant women and mothers face significant barriers to treatment because society views their misuse of substances as an inability to fulfill their main societal roles. Thus, pregnant and parenting women are seen as violating the gendered social construct and must be punished for it.

Gendered stigma barriers to treatment must be addressed to support healing and recovery for all women with SUD. Stigma-based cultural norms and societal expectations about gender cannot be dismantled overnight. However, important support tools like harm reduction can be invaluable to treatment and recovery for women.

Understanding Harm Reduction: Dismantling Barriers to Treatment

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), harm reduction is an evidence-based approach designed to equip an individual with life-saving tools and information about substance use. Harm reduction acknowledges that risk and harm cannot be completely eliminated. Moreover, even when desired, you cannot overcome challenges with substance misuse and SUD overnight. Therefore, the goal of harm reduction is to provide tools and information that empower one to succeed. 

Adaptive strategies and practices empower a person to make choices that lead to a healthy, self-directed, and purpose-filled life. Harm reduction is an invaluable approach that utilizes community-driven public health strategies to effect positive change in countless lives. From prevention and risk reduction to health promotion, harm reduction can be utilized in a variety of systems. Whether it is information on contraceptive safety or connecting one to SUD services on overdose prevention there are many helpful tools available. 

Listed below are a few harm reduction strategies that can be used to support the well-being of pregnant women:

  • Building a plan of action
  • Educational materials
  • Motivational interviewing techniques
  • Seeking gender-sensitive and responsive healthcare providers

For pregnant people and parents with SUD, harm reduction strategies can be instrumental in prevention, treatment, and recovery. Some of the ways harm reduction can support your SUD treatment and pregnancy include:

  • Prevents overdose and infectious disease transmission
  • Improves physical, mental, emotional, and social well-being
  • Lowers barriers to accessing healthcare services
    • Physical health, substance use, and mental health disorder treatment
  • Improves health outcomes for parents and infants
    • Fewer instances of premature birth and low birth weight
    • Babies are more likely to be discharged from the hospital with their parent(s)
  • Increases engagement and retention of prenatal services
  • Improves breastfeeding rates
  • Helps facilitate early attachment
  • Supports healthy childhood development

SUD stigma and other barriers to treatment for pregnant women cannot be dismantled in one fell swoop. However, harm reduction strategies can empower individual and community efforts to ensure the well-being of women and children. With greater awareness and knowledge, we are reminded that we are not alone.

Dismantling Barriers to Treatment at New Creation Recovery

At New Creation Recovery, we recognize the importance of Christian-based drug rehab for women to support healing the whole person. Often women are not given the support needed to effectively respond to an array of challenges in every life sphere. SUD and other mental health disorders are only one of the spheres in which women’s needs have been neglected. 

Therefore, we are committed to providing holistic and evidence-based treatment to support treatment and recovery. With tailored holistic care, you can rebuild trust with providers to foster safety in healthcare and treatment settings. Through access to services like psychoeducational groups and dual diagnosis treatment, you can dismantle barriers to lead a fulfilling life in recovery.

Challenges with substance use and stigma can impede access to prenatal care and other resources during pregnancy. Pregnant women and parenting women with substance use disorder (SUD) experience numerous barriers to treatment and recovery. SUD stigma coupled with norms and societal expectations of gender roles for women contribute to treatment barriers. Gendered SUD stigma leads to harsher judgment and shaming for pregnant women and mothers that disrupts help-seeking behaviors and impedes access to health, SUD, and mental health treatment. However, an evidence-based approach like harm reduction can support treatment and recovery through tools and information. At New Creation Recovery, we are committed to providing holistic gender-specific treatment to address the unique experiences of women. Call us at (877) 868-5730 today.