Substance Misuse in Pregnancy Angela Geraghty - Specialist Midwife Tel: (Office) 0116 258 5990 (Mobile) 07966 558286 (Fax) 0116 258 7262
ACCESS & AWARENESS • Women need to be able to access the services • Increase awareness of services • Take care into the community • Assertive Outreach – do not wait for them to come to us!
• Drug/Alcohol misusers are known not to access general health services until late pregnancy (Drug misuse and dependence 2007) • Thus increases risk to both Mother and Baby. • Drug treatment programmes can enable better outcomes during pregnancy, childbirth and infant development. • Regardless of continuing illicit drug or alcohol use. • By opportunistic care and health promotion during engagement.
• There is a reduced window of opportunity to engage these women and therefore it is important to take the care to them in order to maintain their involvement. • The Specialist Midwife is a key person in linking all services to provide support, advice and care for both mother and baby
Multi-Disciplinary Approach • Involvement by all agencies is vital. Offering support with • • Financial issues Psychological issues Social issues Domestic issues. • Comprehensive, direct and easy referral process is vital for continuity of care • Availability of a self referral process
Clinic Development • Specialist Clinic – Alternate Tuesdays pm involving Cons, CDT, SW, Specialist Midwife and other co-opted members as required. • Midwifery Led Clinics: • Paget House • Cameron Stastny • Criminal Justice Integration Team, Nelson Street
New Guidelines & Protocols • New Guidelines on caring for this client group • New Referral process to Specialist Midwife for clients identified by CMW at booking appt. • Clear protocol for care and identification of client needs & referral to specialist clinic. • Clients engaged in care can receive shared care between CMW and Specialist Midwife/Clinic • Clients difficult to engage will be caseloaded by the Specialist Midwife.
Further Development of Services • Training for staff in substance misuse • Development of a screening tool for early identification of vulnerable women to enable them early support and access to services. • Comprehensive multi-disciplinary care plans to ensure a seamless service
• References • Drug Misuse and dependence – UK guidelines on clinical management. Do. H 2007 • Drugs: protecting families and communities – The 2008 drug strategy. HM Government 2009 • Getting Our Priorities Right. Scottish Executive. 2003 • Hidden Harm. Responding to the needs of children of problem drug users. Home Office 2003 • The Children's Act 1989. HMSO • Antenatal Care. Routine care for healthy pregnant women. National Institute of Clinical Excellence. 2003 • Working Together to Safeguard Children. Do. H 1999 • Medications in mother's milk. T Hale, Pharmasoft publishing 2004 • RCOG green top guidance, statement number 5 – alcohol consumption and the outcomes of pregnancy, March 2006 • Substance Misuse in Pregnancy, A resource book for Professionals. Drugscope 2005
Street Names • • • Benzo’s Brown/Smack Snow/White Bubbles/Meow Uppers/Speed Blow/Skunk • • • Tranquilisers Heroin Cocaine Mephedrone/MCAT Amphetamines Cannabis
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