Browsing by Author "Scott, Lisa Fath"

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    Experience of Maternal Narcotics Users with Fetal and Infant Loss throughout the Infant Life Cycle
    (Office of the Vice Chancellor for Research, 2016-04-08) Scott, Lisa Fath; Shieh, Carol; Umoren, Rachel A.; Conard, Teri
    Objective: Fetal or infant loss is a painful and traumatic experience for all mothers. Literature, however, has been limited in describing maternal experience from pregnancy to the time when a baby dies. This study explored the experience of mothers using prescribed or illicit opioids and encountering fetal or infant loss. Design: A qualitative approach using a reflexive iteration process was used to identify maternal experience across an infant’s life cycle. Participants: Eleven mothers (mostly white, single, less than a high school education) with a history of using prescribed or illicit opioids participated in the semi-structured telephone or in person maternal interview portion of the Fetal and Infant Mortality Review in a Midwest county. Methods: Interview transcripts were first coded. Codes with similar meaning were grouped into categories. Categories sharing similar features were collapsed into common themes. Each phase of analysis was performed and checked by three investigators. Results: Four common themes were identified throughout the entire life cycle of the infant: not being heard, dealing with medical complications, reproductive health, and grief, guilt and bereavement. Mothers perceived that their needs and concerns were not carefully attended to by care providers. They were overwhelmed by medical information about pregnancy and infant complications. Participants did not plan for the pregnancy or use contraception prior to the pregnancy but did use contraception in the post-partum period. Many mothers struggled with grief and loss. Additional themes included care needs for substance use and mental health and taking action and making decisions for the baby’s life. Conclusions: The findings suggest women experiencing opioid use have education and care needs when dealing with fetal/infant loss. When developing interventions for these women, clear communication about medical complications, emotional and bereavement support, and services to help these women prevent unplanned pregnancy are needed.
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    Policy perceptions of US state public health and child and family services regarding maternal opioid use and neonatal exposure
    (Elsevier, 2019) Scott, Lisa Fath; Stone, Cynthia; Duwve, Joan; Health Policy and Management, School of Public Health
    Objective To explore how state legislatures and departments of health are responding to the public health and economic issues of increases in opioid use disorder and the impact on pregnant women and infants. Design The design was a non-experimental descriptive study using a mixed methods survey research approach. Setting Electronic and telephone survey of individuals from state departments of health associated with departments of behavioral health and substance use, or child and family services. Participants Fifty-two respondents employed by individual state departments of health and child and family services. Methods Univariate analysis and frequency distribution of ordinal variables was completed. Thematic analysis was used to analyze free text questions and identify themes. Results All states reported recent changes or plans to address the problem of opioid misuse in their state. Many respondents feel their state continues to lack adequate services for treatment. Some states are exploring unique methods for addressing this in a safe and timely fashion, such as moving medication-assisted treatment to primary care and expanding licensure to Primary Care Physicians (PCPs) and nurse practitioners. Conclusions Our findings demonstrate an increased commitment throughout the United States to enhance access to clinically appropriate treatment of substance use disorder particularly during pregnancy, consider unique methods for addressing the problem of opioid dependency, and increase education and primary prevention programs.