Abstract
IntroductionDrug use during pregnancy can have negative effects on maternal and child health. However, there is a dearth of data regarding drug use among pregnant women in Kenya, where illicit drug use is on the rise. In this paper, we report factors influencing women’s decisions to use drugs during pregnancy.MethodsIn 2015, we conducted in-depth interviews and focus group discussions with 45 women who inject drugs and five key stakeholders involved in provision of services to people who use drugs in coastal Kenya. Inductive thematic analysis was conducted to draw out themes related to key determinants of drug use during pregnancy.ResultsFour key themes emerged outlining determinants of drug use during pregnancy: (i) the use of drugs to cope with the stress of unexpected pregnancy, (ii) the continued drug use during pregnancy to manage withdrawal, (iii) the dual effect of pregnancy on drug use either as a facilitator or as a moderator of drug use, and (iv) the role of male intimate partner in influencing women’s drug use during pregnancy.ConclusionOur paper reports women’s drug use during pregnancy and the factors influencing this phenomenon. To safeguard the health and well-being of pregnant women and their unborn children, there is a need for education and awareness raising, implementing couple-based harm reduction approaches to leverage on positive male influences, improving availability of drug treatment, and provision of family planning interventions for women who use drugs.
Highlights
IntroductionWomen make up a third of the people who use drugs globally (Larney et al 2015). A significant proportion of these women are of reproductive age, which means that drug use and pregnancy are likely to converge
Drug use during pregnancy can have negative effects on maternal and child health
Our findings indicate a need to put in place interventions to mitigate drug use during pregnancy in coastal Kenya
Summary
Women make up a third of the people who use drugs globally (Larney et al 2015). A significant proportion of these women are of reproductive age, which means that drug use and pregnancy are likely to converge. As noted by Ayon et al (2017), limited attention has been paid to the broader sexual and reproductive health needs of women who use drugs in Kenya This is not necessarily surprising given that harm reduction services in Kenya are nascent (Rhodes et al 2016). Recognizing that drug use can occur in the context of pregnancy—as has been reported in other countries (Black et al 2012)—is an important step towards responding to maternal and reproductive health needs of female drug users in Kenya This is relevant given the documented stigma towards women who inject drugs in Kenya (Mburu et al 2018a), including from health care providers (Ayon et al 2017; Guise et al 2016) which limits the access and utilization of health services by women who use drugs. We build on previous work by Yotebieng et al (2016) who explored alcohol use in pregnancy, to report factors influencing women use of a wider variety of drugs during pregnancy
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