READINGS ON PREGNANCY &
SUBSTANCE USE

 

Readings on Pregnancy & Substance Use (39KB pdf)

» Highlights
» Pregnancy and Substance Use: Understanding the issues
» Level 1 Prevention: Broad prevention and public education campaigns
» Level 2 Prevention: Brief intervention with women in childbearing years and pregnant women
» Level 3 Prevention: Supporting pregnant women with alcohol and other health/social problems
» Community Capacity Building


Over the last couple of years, when doing regional education across British Columbia with service providers through the ActNow BC Health Choices in Pregnancy initiative we have found the following resources of interest. These resources are materials about approaches to working with pregnant women and mothers with substance use problems, with the goal of preventing FASD:

Highlights

Motivational Interviewing Webcast Resource List
A list of selected Motivational Interviewing resources related to supporting women's health in pregnancy and childbearing years.
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Motivational Interviewing in Health Care: Helping Patients Change Behavior
Rollnick, S., Miller, W.R., & Butler, C.C. (2007). The Guildford Press.

Written specifically for health care professionals, this book presents tools to enhance communication with patients and guide them in making choices to improve their health. Engaging dialogues and vignettes bring to life the core skills of motivational interviewing (MI) and show how to incorporate this brief evidence-based approach into any health care setting.

Highs & Lows:
Canadian Perpectives on Women and Substance Use
Poole, N. & Greaves, L. (2007). Centre for Addiction & Mental Health.

Women’s and girls’ substance use is now recognized as an important health, economic and social issue in Canada. However, most books about alcohol and other drug use do not address the unique needs and circumstances of this population. Highs & Lows draws on the latest theory and research to offer strategies for improving practice and developing  policy to support women with substance use problems. This unique book includes contributions from nearly 100 experts on women’s substance use, including psychiatrists, psychologists, social workers, clinical therapists, health promoters, academics, alternative health care providers, women’s health advocates — and women who have personally been affected by substance use.
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With Child: Substance Use During Pregnancy, A Woman-Centred Approach
Boyd, S.C. & Marcellus, L. (2007). Halifax, NS: Fernwood Publishing

Info Sheet: Barriers to accessing support for pregnant women and mothers with substance use problems
FASD Network Action Team on Prevention from a Women's Health Determinants Perspective (2007).
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From Stigma to Support: Pregnant Women and Alcohol
Poole, N. & Urquhart, C. (2006). Visions: BC’s Mental Health and Addictions Journal, Spring; 2(9):16.
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Preventing Alcohol Exposed Pregnancies: A Randomized Control Trial
American Journal of Preventive Medicine, 32(1), 1-10. Floyd, R. L., Sobell, M., Velasquez, M. M., Ingersoll, K., Nettleman, M., Sobell, L., et al. (2007).

This article describes a randomized controlled trial documenting the benefits of brief motivational interviewing in preventing alcohol exposed pregnancies. It can be found on the Centers for Disease Control and Prevention website.

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Pregnancy and Substance Use: Understanding the issues

Reducing the Impact: Working with pregnant women who live in difficult life situations
Best Start. (2002). Toronto, ON: Best Start: Ontario's Maternal, Newborn and Early Child Development Resource Centre.

This 78 page booklet supports service providers to “re-think the ways in which they work with women of low socio-economic status in order to provide more effective programs and initiatives.”
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A Motherhood Issue: Discourses on mothering under duress
Greaves, L., Varcoe, C., Poole, N., Morrow, M., Johnson, J., Pederson, A. & Irwin, L. (2002).Ottawa, ON: Status of Women Canada.

This study investigates how situations of mothering under duress are discussed in Canadian policy documents, media portrayals and women's experiences. A mothering framework is recommended to guide the development of policies that recognize, respect and restore the mother-child unit.
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Mother and Child Reunion: Preventing Fetal Alcohol Syndrome by Promoting Women’s Health
Poole, N. (2003). Vancouver, BC: British Columbia Centre of Excellence for Women's Health.

This policy document succinctly describes the three levels of prevention that together comprise a comprehensive prevention response (12 pages plus references).
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Apprehensions: Barriers to Treatment for Substance-Using Mothers
Poole, N. & Isaac, B. (2001). Vancouver, BC: British Columbia Centre of Excellence for Women's Health.

This report on barriers and supports for mothers as they attempt to access substance use treatment in BC, is a compelling statement of how the policy and service response could be improved to support women in accessing the care they need and to prevent FASD.
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Substance Use and Pregnancy: Conceiving Women in the Policy Process
Rutman, D., Callahan, M., Lundquist, A., Jackson, S., & B. Field
(2000). Ottawa, ON: Status of Women Canada.

This research report examines how policy in Canada deals with the issue of substance use during pregnancy and suggests alternative ways of addressing this problem that may prove less polarizing and punitive toward women.
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A Study of the Service Needs of Pregnant Addicted Women in Manitoba
Tait, C. (2000). Winnipeg: Manitoba Health.

This report on the service needs of pregnant women is based on interviews with 74 women in 3 locations across Manitoba and 85 service providers who work with these women. Particular attention is paid to the needs of Aboriginal women.
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Level 1 Prevention: Broad prevention and public education campaigns

Keys to a successful alcohol and pregnancy communication campaign
Best Start. (2003). Toronto, ON: Best Start: Ontario's Maternal, Newborn and Early Child Development Resource Centre.

This group has led several province wide campaigns on prevention of FASD and shares key resources and learnings at this website.
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What We Have Learned:
Key Canadian FASD Awareness Campaigns

Burgoyne, W. (2006). Ottawa: Public Health Agency of Canada.

Description of recent Canadian public awareness activities on prenatal alcohol exposure, and includes information on those evaluated.
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Level 2 Prevention: Brief intervention with women in childbearing years and pregnant women

Alberta Alcohol and Drug Abuse Commission (2003)
Help Kit. Edmonton, AB: AADAC

This kit includes resources from the Services for Women and Women and Substance Use series. Contains posters, pamphlets and a help guide. The Help Kit is a strong package of resources for professionals on understanding and intervening on women’s substance use in pregnancy. It is available for $130.00 from AADAC. AADAC’s other resources on women and substance abuse and prevention of FASD are available here.

BC Reproductive Care Program (2005)
BCRCP Guidelines for Alcohol Use in the Perinatal Period and Fetal Alcohol Spectrum Disorder. Vancouver, British Columbia.

Guidelines developed by the BC Reproductive Care Program that focus on the impact of alcohol use on women’s health in pregnancy and fetal development. Evidence based approaches to supporting women to make changes to their alcohol use in the perinatal period are outlined to assist service providers in their work with women.
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Consultations About Changing Behaviour

Rollnick, S., Butler, C.C., McCambridge, J, Kinnersley, P., Elwyn, G., & Resnicow, K. (2005). BMJ, 331: 961-963.

Persuading patients to change behaviour that is damaging their health can be difficult. Changing the style of consultation could improve the experience for doctors and patients.
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Health Behavior Change: A Guide for Practitioners
Rollnick, S., Mason, P., & Butler, C. (1999). New York: Churchill Livingstone.

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BC Reproductive Care Program (2006)
BCRCP Guidelines for Tobacco Use in the Perinatal Period. Vancouver, British Columbia.

Guidelines developed by the BC Reproductive Care Program that focus on the impact of tobacco use on women’s health in pregnancy and fetal development. Evidence based approaches to supporting women to make changes to their tobacco use in the perinatal period are outlined to assist service providers in their work with women.
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Canadian Centre on Substance Abuse (2002)
FASD Tool Kit - Women at Risk and Community Development sections

This resource was developed by the Canadian Centre on Substance Abuse in collaboration with the Breaking the Cycle program in Toronto and is designed for professionals working in communitybased agencies who in the course of their work, have contact with women with substance use issues. Provides a good overview of screening, motivational interviewing and harm reduction practice with pregnant women.
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Canadian Centre on Substance Abuse (2005)
Nurturing Change: Working effectively with high-risk women and affected children to prevent and reduce harms associated with FASD.

This resource was developed by the Canadian Centre on Substance Abuse in collaboration with the Breaking the Cycle program in Toronto and is designed for The manual was written to enhance the skills of service providers working in prenatal and early childhood settings in Canada to: Engage and support pregnant women who use alcohol or other substances; Identify and support children who may be affected by prenatal alcohol exposure, and their families.
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Canadian Centre on Substance Abuse (2001)
Respect is key to helping pregnant women with substance use problems: a conversation with Pam Woodsworth.

Offers an excellent overview of recommended approaches to working with women. Often short summaries of recommended approaches such as this are useful to programs and policy makers.
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Centre for Addiction and Mental Health (2003)
Is it Safe for My baby? Toronto, ON.

This booklet reviews the impact of all substances, from cough syrup to cocaine, on the developing fetus as well as considerations for breastfeeding. It is useful for service providers and women and does not divide substances into licit and illicit drugs, thereby reducing the stigma. It can be purchased through the publications department at the Centre for Addiction and Mental Health.
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Expecting to Quit: Best Practices in Smoking Cessation During
Pregnancy
(2005)
Vancouver, BC: British Columbia Centre of Excellence for Women's Health.

This report examines better practices in tobacco cessation during pregnancy. The results are contextualized in the wider literature of women’s health, women-centred care and women’s tobacco use.
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The SMART Guide: Motivational approaches within the Stages of Change for pregnant women who use alcohol: A training manual for service providers
Leslie, M., & Reynolds, W. (2002). Kingston ON: Action on Women's Addictions Research and Education (AWARE) and Breaking the Cycle

This guide provides in-depth information on how to apply evidence-based motivational interviewing practices when working with pregnant women.

Motivational Interviewing: Preparing People for Change
(2nd ed.)

Miller, W. R., & Rollnick, S. (2002). New York, NY: The Guilford Press.

In this revised second edition of their book, Miller and Rollnick emphasize the importance of understanding the spirit and principles of MI. They provide practical approaches to working with ambivalence and resistance in order to facilitate behaviour change. A number of the chapters are dedicated to the use of MI with special populations such as medical and public health settings, group and couples work as well as working with those who struggle with dual disorders.
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Level 3 Prevention: Supporting pregnant women with alcohol and other health/social problems

Seeking Safety: A Treatment Manual for PSTD and Substance Abuse
Najavits, L. M. (2002). New York, NY: The Guilford Press.

Seeking Safety is one of five models found to be successful in a large 5 year national study in the USA about working with women in an integrated way on trauma, mental health and substance use issues.
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Breaking the cycle: The evaluation report (1995- 2000)
Pepler, D. J., Moore, T. E., Motz, M., & Leslie, M. (2002). Toronto, ON: Breaking the Cycle.

The evaluation of the Breaking the Cycle provides a wealth of information on the needs of high risk mothers and children, and the outcomes achieved through comprehensive, flexible, one-stop programming.
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Evaluation Report of the Sheway Project for High Risk Pregnant and Parenting Women
Poole, N. (2000). Vancouver BC: British Columbia Centre of Excellence for Women's Health.

This evaluation of the work of the Sheway program in Vancouver documents how offering services from a compassionate, holistic and harm reduction perspective can improve outcomes for high risk mothers and their infants.
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Group Treatment for Substance Abuse: Stages-of-Change Therapy Manual
Velasquez, M.M., Maurer, G.G., Crouch, C., DiClemente, C.C. (2001). The Guildford Press: New York.

This group manual provides concrete and practical interventions that can be applied at every stage of change from precontemplation to maintenance. Guidelines for implementing the groups are provided as well as strategies for using a motivational interviewing style.
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Community Capacity Building

The Community Development Handbook
Government of Canada. (1999). Minister of Public Works and Government Services Canada.

This introductory handbook is an introductory guide to community development and capacity building. It is designed primarily for those who have an interest in community development but who may not have an in-depth understanding of the concept, the process or the resources available across Canada.
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Northern Family Health Society
Some basics of community development and other detailed steps of what they did in Prince George at the Northern Family Health Society to develop a community vision for FASD prevention.
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All Together Now: Creating a Social Capital Mosaic
Ricks, F., Charlesworth, J., Bellefeuille, G., & Field, A. (1999). Victoria, BC: Frances Ricks and the Vanier Institute of the Family.

These authors have all worked in the child, youth, family, and community services field. And from their experience they question conventional community development strategies and identify the elements and values underling new approaches to community development built on their concept of a social capital mosaic.
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