Prenatal Substance Misuse: Exploring Healthcare Providers' Attitudes and Perceptions

Abstract

To maximize beneficial outcomes for babies and mothers in substance misuse situations, it is necessary to understand the current societal factors and the stigma that healthcare providers may be imposing on the families. More than 5% of all pregnancies are affected by prenatal substance misuse prompting a public health crisis. The negative effects from drug misuse on the growing baby ranges from neonatal abstinence syndrome (NAS), mental retardation, behavioral abnormalities, and neurological deficits. The exposure also causes lengthy hospitalizations for babies and high financial costs. The provider must balance their own feelings and beliefs about substance misuse in pregnancy while simultaneously providing appropriate and supportive care to the mother. However, health-related stigma can occur as providers must care for both mother and baby, in an often stressful work environment. This research explored structural stigma, which broadly encompassed the policies and cultural practices, towards women with prenatal substance misuse among providers in a maternal/fetal healthcare unit. The study, with 117 participants from an area hospital system, examined several variables including the attitudes, perceptions, and stigma among healthcare providers towards prenatal substance misuse. A factorial MANOVA and descriptive analysis was used to assess the data. Among the findings, a significant difference was found between the type of employment discipline and a practitioner’s attitudes and level of structural sigma. Direct Care Nurses had an increased negative attitude towards women with prenatal substance misuse. Additionally, there was a strong correlation (r=0.612) between the cause of substance misuse and a healthcare provider’s attitudes towards prenatal substance misuse. If the provider believed substance misuse stemmed from a moral flaw or failing, he/she had a more negative attitude towards women with prenatal substance misuse. The current study identified the potential stigma and attitudes among healthcare providers and offered insight into the practice methods within the healthcare setting. Specifically, a three-tiered protocol to improve the culture, education, and practice within the hospital setting emerged.