Polly Radcliffe

The care pathways of women who use drugs in the perinatal period: findings of a qualitative longitudinal study

Background / Aims: Substance use in pregnancy is a multifaceted public health problem with many confounding factors and implications for the long-term wellbeing of both mothers and children. This study aims to understand the experiences of women receiving multidisciplinary and integrated treatment and the range of care models available.

Methods: The study used a prospective longitudinal design, involving up to five in-depth interviews with 36 women in four different research sites in England and Scotland from early pregnancy up to 18 months after birth, tracking women’s experiences of care over time. Interviews were transcribed verbatim and data were extracted from transcripts using the framework approach.

Results: Preliminary results presented a profile of women with complex histories of disadvantage and abuse, with many having previously lost care of their children. Arrangements of services varied in the four sites impacting how women experienced care pathways. Delivery and inpatient care for women and their babies and the immediate post-natal period were identified as points at which there is an acute need for coordinated care and access to specialist mental health, social care, and treatment services.

Conclusions: Women reported having highly variable experiences of antenatal and postnatal services in different research sites, varying from highly stigmatising to non-judgemental care. We highlight a particular gap postnatally where women often find that the wide array and often specialist antenatal support they received is no longer as readily available, and they are often left to navigate motherhood and complex systems on their own.