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Prenatal use of drugs and substances remains a major public health problem globally. The use of drugs and substances is associated with deleterious maternal and fetal effects. Tobacco is the most commonly used substance and then followed by alcohol among pregnant and breastfeeding mothers (Liew,Ritz, Rebordosa, Lee & Olsen, 2014). According to a 2012 survey on Drug Use and Health, 6.0% of women who are pregnant are engaged in the usage of illegal drugs while 8.6% drink alcohol while 15.9% of women smoke cigarette (Amos, Greaves, Nichter & Bloch, 2012). This means that more than 380,000 unborn children are exposed to illegal substances, 560,000 to alcohol and more than 1 million are exposed to alcohol (Amos et al., 2012).
The effects of drug usage on the foetus of a pregnant mother vary depending on the type of drug, the point it has been exposed as well as degree of use. Alcohol use for pregnant mothers results to development of fetal alcohol syndrome and fetal alcohol effects (Wendell, 2013). It also results in the newborn child being below the normal birth weight, abruption of placenta as well as increased infant mortality. Additionally, use of illegal substances results to preterm delivery, placental abruption as well as cognitive impairment (World Health Organization.2014). Additionally, abuse of substance for breastfeeding mothers results to poor nutrition and this may affect the quality of milk the child is consuming and hence impacting on their health. Despite the unfavorable impacts of substance use on fetal development being well known and documented, there has not been an appropriate policy in place to address this public health problem. This paper therefore seeks to identify and discuss strategies that can be effectively used to reduce substance, tobacco and alcohol use among pregnant mothers.
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The usage of alcohol and other drugs for pregnant and breastfeeding mothers is a major public health problem globally. According to ACOG Committee on Health Care for Underserved Women, (2012), one of the ways in which this problem can be solved is by increasing campaigns to create awareness. This campaign should mainly target young prospective mothers who have the highest chances of using alcohol and other substances during their pregnancy. He suggests that it is critical that the campaigns target young girls who are beyond the age of 18. He argues that it is difficult to prevent drug use during pregnancy for persons who had been addicted to using the drugs before they fell pregnant. It is therefore very critical that the Government and other NGO`s focus on preventing drug use among young girls in order to ensure that even during pregnancy, they do not use drugs. Another strategy for solving the problem of drug and alcohol abuse among pregnant mothers is putting in place stringent laws which will lead to prosecution of mothers found to have abused drugs during the period of pregnancy. (Passey et al.,2013) suggests that federal laws should be designed to make it illegal for a pregnant mother to use drugs or alcohol when they are pregnant. This can be justified because alcohol and drug abuse poses serious health risks to the foetus. Women who go to seek prenatal care should be subjected to compulsory testing and those found pregnant should be prosecuted according to the law. This law will be very crucial in discouraging drug and substance abuse among pregnant and breastfeeding mothers and hence go a long way in solving this health problem (Popova, Lange, Probst,Gmel & Rehm, 2017). Women who use drugs during pregnancy should be taken to rehabilitation centers. Pregnancy is a very crucial and delicate stage in the life of a woman and it is therefore very critical that the mother protects themselves as well as the foetus growing inside them. In order to help pregnant mothers who use drugs, it is critical to take them through rehabilitation and counseling in order to help get rid of this habit.
In order to solve the public health problem of drug use among pregnant and breastfeeding mothers, it is important that we use a combination legal and health techniques to solve the problem. One of the most effective techniques of solving this problem is putting measures in place to sensitize women in general on dangers of using drugs (Jonas et al., 2012. P.g 651). This is because, if a woman was using drugs for a longtime and they decide to stop when they become pregnant, it brings some complications during pregnancy as well as childbirth. Therefore, it is not prudent to wait until a woman gets pregnant in order to find a way of solving the problem. Awareness campaigns should be carried out targeting young girls from young age in order to discourage them from using drugs. The problem of drug use can also be solved by offering the pregnant women treating and counseling services (Stone, 2015).
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Pregnant mothers who use drugs should not be condemned by the society without trying to offer them any meaningful help. Pregnant mothers who use drugs undergo many struggles trying to stop the habit of drug use. Without the help and the support of the society in general, it is difficult for these women to overcome this problem no matter how they are willing (Jones,Finnegan & Kaltenbach, 2012). Special treatment and rehabilitation services should be in place to ensure that pregnant mothers who use drugs get special help when they visit the clinic(World Health Organization. 2014). They should be put under a comprehensive program to help them avoid drugs during the entire period of pregnancy. The state has a legal and moral obligation to protect the life of an unborn child. It is therefore critical that both federal and state Governments enact laws to protect the foetus which is a prospective life from being harmed and abused by the mother through use of drugs (Coleman-Cowger, Schauer, & Peters,2018).Use of the law is critical in discouraging mothers from abusing drugs. This is because doing so would put them at a risk of going to jail for abusing unborn child. Without legal backing, it is difficult to reduce or put to an end this public health problem.
Evidence shows that sensitization of women at a young age is critical in helping avoid the use of drugs during pregnancy. According to Coleman-Cowger, Schauer & Peters, (2017) creating awareness among women could reduce the chances their chances of abusing drugs during their reproductive years. It is therefore very critical that girls from early teens are sensitized on the dangers of using drugs since it helps in reducing the chance of them abusing drugs at a later stage in life.
Research also indicates that a supportive family and society helps in solving the health challenge of drug use during pregnancy (Coleman-Cowger, Schauer & Peters, 2018). Women undergo very many difficulties during and before pregnancy. Some of the challenges that they undergo may push them to use drugs during pregnancy. The psychological issues that they face may cause them to abuse drugs and hence risking the health of their children. A supportive family and society can help women avoid this situation and hence help this problem (Amos, Greaves, Nichter & Bloch, 2012).
Research also proves that offering treatment to pregnant mothers who use drugs can significantly help in solving this health problem (Hasin, Shmulewitz & Keyes, 2019). Offering specialized treatment can help the mothers who were already addicted reduce the rates of using drugs and they can eventually completely stop taking drugs (Jones, Finnegan & Kaltenbach, 2012). Psychological therapy has also been found to be very effective in helping pregnant women avoid drugs.
The use of drugs and substances is associated with tremendous unfavorable effects on the health status of both the foetus and the mother. Use of drugs during pregnancy has resulted to the birth of children to test positive for drugs and this simply means that they are drug addicts against their choice. Tobacco is the most commonly used substance and then followed by alcohol among pregnant and breastfeeding mothers in Australia. According to a 2012 survey on Drug Use and Health, 6.0% of pregnant women use illegal drugs while 8.6% drink alcohol while 15.9% of women smoke cigarette. This means that more than 380,000 unborn children are exposed to illegal substances,560,000 to alcohol and more than 1 million are exposed to alcohol.
Some of the strategies that could be used in solving this public health problem is the labeling of various drugs with warnings indicating the dangers the drugs may pose to the unborn child. The other strategy is providing continuous treatment and counseling in the entire course of the pregnancy. The other potential solution to the problem is the enactment of laws and policies at federal and state level which will criminalize the usage of any type of drug during pregnancy. The paper also discusses the counter arguments for these proposals and provides a justification on why these proposals are still appropriate.
ACOG Committee on Health Care for Underserved Women. (2012). ACOG Committee Opinion No. 524: Opioid abuse, dependence, and addiction in pregnancy. Obstetrics and gynecology, 119(5), 1070.
Amos, A., Greaves, L., Nichter, M., & Bloch, M. (2012). Women and tobacco: a call for including gender in tobacco control research, policy and practice. Tobacco control, 21(2), 236-243.
Coleman-Cowger, V., Schauer, G., & Peters, E. (2018). Corrigendum to “Marijuana and tobacco co-use among a nationally representative sample of US pregnant and non-pregnant women: 2005–2014 National Survey on Drug Use and Health findings” [Drug Alcohol Depend. 177 (2017) 130–135]. Drug And Alcohol Dependence, 185, 141. doi: 10.1016/j.drugalcdep.2018.02.002
Coleman-Cowger, V., Schauer, G., & Peters, E. (2017). Marijuana and tobacco co-use among a nationally representative sample of US pregnant and non-pregnant women: 2005–2014 National Survey on Drug Use and Health findings. Drug And Alcohol Dependence, 177, 130-135. doi: 10.1016/j.drugalcdep.2017.03.025
Hasin, D., Shmulewitz, D., & Keyes, K. (2019). Alcohol use and binge drinking among U.S. men, pregnant and non-pregnant women ages 18-44: 2002 to 2017. Drug And Alcohol Dependence, 107590. doi: 10.1016/j.drugalcdep.2019.107590
Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive therapy and research, 36(5), 427-440.
Jones, H. E., Finnegan, L. P., & Kaltenbach, K. (2012). Methadone and buprenorphine for the management of opioid dependence in pregnancy. Drugs, 72(6), 747-757.
Jonas, D. E., Garbutt, J. C., Amick, H. R., Brown, J. M., Brownley, K. A., Council, C. L., ... & Yeatts, J. (2012). Behavioral counseling after screening for alcohol misuse in primary care: a systematic review and meta-analysis for the US Preventive Services Task Force. Annals of internal medicine, 157(9), 645-654
Liew, Z., Ritz, B., Rebordosa, C., Lee, P. C., & Olsen, J. (2014). Acetaminophen use during pregnancy, behavioral problems, and hyperkinetic disorders. JAMA pediatrics, 168(4), 313-320.
Passey, M. E., Bryant, J., Hall, A. E., & Sanson-Fisher, R. W. (2013). How will we close the gap in smoking rates for pregnant Indigenous women?. The Medical Journal of Australia, 199(1), 39-41.
Popova, S., Lange, S., Probst, C., Gmel, G., & Rehm, J. (2017). Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: a systematic review and meta-analysis. The Lancet Global Health, 5(3), e290-e299.
Stone, R. (2015). Pregnant women and substance use: fear, stigma, and barriers to care. Health & Justice, 3(1), 2.
Wendell, A. D. (2013). Overview and epidemiology of substance abuse in pregnancy. Clinical obstetrics and gynecology, 56(1), 91-96.
World Health Organization. (2014). Guidelines for the identification and management of substance use and substance use disorders in pregnancy.
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