Abstract
IntroductionConsumption of substances is a highly controversial behaviour, with those who do so commonly viewed as deviants, even criminals, or else as out of control addicts. In other work we showed that the use of substances by women who are pregnant or have recently become parents was mainly viewed by health and social care providers as morally wrong. Problematic substance use was framed through the narrow lens of gendered responsibilisation, resulting in women being seen primarily as foetal incubators and primary caregivers of infants.MethodsIn this follow-up paper we examine descriptive and qualitative data from a convenience sample of biological mothers and fathers (N = 34) recruited as part of a larger mixed methods study of the development and early implementation of an integrated primary maternity care program. We present a description of the participants’ backgrounds, family circumstances, health status, and perception of drug-related stigma. This is succeeded by a thematic analysis of their personal views on substance use during both pregnancy and the transition to parenthood.ResultsOur results show that while many mothers and fathers hold abstinence as the ideal during pregnancy and early parenting, they simultaneously recognize the autonomy of women to judge substance use risk for themselves. Participants also call attention to social structural factors that increase/decrease harms associated with such substance use, and present an embodied knowledge of substance use based on their tacit knowledge of wellness and what causes harm.ConclusionsWhile these two main discourses brought forward by parents concerning the ideal of abstinence and the autonomy of women are not always reconcilable and are partially a reflection of the dissonance between dominant moral codes regarding motherhood and the lived experiences of people who use substances, service providers who are attuned to these competing discourses are likely to be more effective in their delivery of health and social services for vulnerable families. More holistic and nuanced perspectives of health, substance use, and parenting may generate ethical decision-making practice frameworks that guide providers in meeting and supporting the efforts of mothers and fathers to achieve well-being within their own definitions of problematic substance use.
Highlights
Consumption of substances is a highly controversial behaviour, with those who do so commonly viewed as deviants, even criminals, or else as out of control addicts
While the purpose of broader study was to inform client harm reduction services offered through HerWay Home, the specific focus of the analysis presented here is to shed light on the views of structurally marginalized expectant and recent parents regarding substance use during pregnancy and early parenting
The structural vulnerability experienced by participants and the disapproval they feel are interwoven throughout their responses to our research question, “How do you define problematic substance use during pregnancy and early parenting?”
Summary
Consumption of substances is a highly controversial behaviour, with those who do so commonly viewed as deviants, even criminals, or else as out of control addicts. Infants with exposure to substances in utero are believed to face multiple health and social challenges, including Fetal Alcohol Spectrum Disorder (FASD), neonatal withdrawal, and higher incidence of placement in foster care and greater risks of perceived and actual child abuse [1, 2]. The Canadian Institute for Health Information (CIHI) reported that in Canada in 2003–2004, 171 newborns were diagnosed with neonatal abstinence syndrome (NAS), with an increase to 654 reported cases in 2010–2011 [8]. This represents in large part an increase in attention and awareness on the part of health professionals
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