Disconnected perspectives: Patient and care provider's experiences of substance use in pregnancy.

Generations of colonialism, abuse, racism, and systemic trauma have contributed to Indigenous women in Canada bearing the greatest burden of substance use in pregnancy. Stigma associated with substance use in pregnancy translates into multiple barriers to women engaging in care. Care providers have key interactions that can act as a bridge or a barrier to care. Patient journey maps were created for women living with substance use (n = 3) and semi-structured interviews (n = 20) were performed to understand perceptions of maternity-care providers around women with substance use in pregnancy at a regional hospital in northern British Columbia. Patient journey maps showed overall emotions of hurt, loss, judgment, and anger at their interface with health care during pregnancy. Providers described gaps in knowledge of substance use in pregnancy and harm reduction. Although care providers overall perceived themselves to be providing compassionate care without bias, the patient journey maps suggested profound judgment on behalf of providers. Ongoing cultural humility and trauma-informed care training along the continuum of care is critical to impacting discrepancies between perceived lack of bias and harm in patient interactions. Acknowledgment of systemic racism's impact on provision of maternity care is critical for health system change. © 2021 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

Citation

Sheona M Mitchell-Foster, Carolyn E Emon, Maria Brouwer, Lucille Duncan Elder, Jessie King. Disconnected perspectives: Patient and care provider's experiences of substance use in pregnancy. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2021 Nov;155(2):170-178

Mesh Tags

PMID: 34496061

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