How can I help address substance use and misuse in pregnancy?

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Service managers and commissioners

Wherever possible, service managers and commissioners should seek to influence public health campaigns in order that they highlight the importance of stopping smoking, drinking and using drugs while pregnant or trying to conceive.

Ensure that:

For drugs and alcohol:

  • services are accessible and relevant to vulnerable families and consistent with related policy commitments
  • relevant information resources are available

For tobacco:

  • staff are educated and trained in tobacco and second hand smoke issues, to the smoking cessation standards identified in A Guide to smoking cessation in Scotland 2010 - Helping smokers to stop: Brief interventions, pp 24-30 (external link)
  • services are accessible and relevant to vulnerable families and consistent with related policy commitments
  • relevant information resources are available
  • ensure compliance with smoke-free legislation and promote associated policies such as ‘no smoking’ on or in NHS premises and property (including vehicles)

Midwives, GPs, Practice Nurses

These practitioners are often a first point of contact for pregnant women and should be familiar with current guidance on effective interventions.

At the earliest opportunity, discuss drug use, drinking habits, smoking status and second hand smoke (SHS) exposure.

For tobacco:

  • undertake carbon monoxide monitoring to assess carbon monoxide levels and SHS exposure, using the standards identified in A Guide to smoking cessation in Scotland 2010 (external link), and record smoking status and CO level in notes
  • offer information and advice on stopping smoking (including Smokeline - 0800 848484) and the hazards of smoking and SHS exposure during and beyond pregnancy
  • for recent quitters and those with a CO reading of 7ppm or above, discuss with them and fast-track their referral to specialist smoking cessation services

For drugs and alcohol:

  • offer information and advice on the risks associated with drinking and using drugs before and during pregnancy and after the birth of the baby
  • carry out alcohol screening, offering an Alcohol Brief Intervention where appropriate
  • refer or signpost alcohol and drug misusers with more complex needs to substance misuse services

Establishing regular communications with - and referral pathways to - specialist service providers and other sources of support, including voluntary sector agencies, is also vital.

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Voluntary sector workers and managers

Voluntary sector agencies often have better contacts with women in vulnerable groups than statutory services.

They can help by:

  • providing information on specialist local services
  • encouraging early contact with a GP or midwife
  • providing information on the risks of misusing alcohol and drugs and tobacco use during pregnancy

Managers can help by establishing good, inter-agency links with specialist service providers and other sources of support.

Employers

Employers can help by:

  • providing information on how to quit smoking and on responsible drinking
  • ensuring compliance with smoke-free legislation and associated policies such as ‘no smoking’ on company premises or in vehicles

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Interventions around substance misuse in pregnancy

Services should be accessible to all pregnant women and their partners and respond to individual needs. This approach is not stigmatising and allows for early intervention before issues become critical.

Detailed guidance for professionals and others in Scotland (external links):

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