Conflict Between Maternal Autonomy and Child Health in Substance-use

Pregnancy Clinical Trial

Official title:

Mother vs. Child? Healthcare Worker Perceptions of Conflict Between Maternal Autonomy and Child Health When Providing Care for Pregnant Women Engaging in Problematic Substance Use

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02797990
• Other study ID #: 10890
• Secondary ID: 201264FI0816115
• Status: Completed
• Phase: N/A
• First received: June 9, 2016
• Last updated: September 7, 2016
• Start date: May 2016
• Est. completion date: September 2016

Study information

• Verified date: May 2016
• Source: London School of Hygiene and Tropical Medicine
• Contact: n/a
• Is FDA regulated: No
• Health authority: United Kingdom: National Institute for Health Research
• Study type: Observational

Clinical Trial Summary

Qualitative project, comprising open-ended semi-structured interviews with healthcare workers, who provide antenatal care to substance-using women.

Description:

Maternal substance use during pregnancy (including legal and illicit substances) is a fairly common global phenomenon, including in the UK. This can have significant effects on pregnancy, infant outcome and enduring consequences into adolescence. Babies born with neonatal abstinence syndrome may spend months in neonatal care units, requiring complex, 24hour care. Here, healthcare workers may experience conflict between preserving maternal autonomy, and the challenge of caring for a withdrawing newborn.

However, there is discrepancy between the objectives of policy-makers "Reducing the harm to children from parental problem drug use should become a main objective of policy and practice" and those recommended in healthcare "These women need supportive and coordinated care during pregnancy." Therefore, conflict arises between mother-centred and child-centred models of caring for pregnant women who use substances.

The objective of the proposed project is to investigate how healthcare workers providing treatment for pregnant women who use illicit substances perceive their duty of care and whether they experience tension between the conflicting objectives of mother-centred and child-centred approaches through semi-structured qualitative interviews. The investigators will explore the ways in which healthcare workers frame problematic substance misuse in pregnant women, what they perceive to be the major challenges in providing care and their views on the responsibility of a mother to have a healthy baby. The main hypothesis is that healthcare workers providing care for pregnant women engaging in problematic substance misuse experience conflict between mother-centred and child- centred approaches to care.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 6
• Est. completion date: September 2016
• Est. primary completion date: August 2016
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Both
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Healthcare workers will be recruited based on their employment status; they must currently provide some form of antenatal are for women who engage in problematic use of substances (limited to illicit drugs, excluding tobacco and alcohol).

• Healthcare workers will not be restricted by age, and all genders will be included. As the research is qualitative, a representative same is unnecessary.

Exclusion Criteria:

• Healthcare workers will be excluded if they do not have experience of providing ante-natal care for women who engage in problematic substance misuse (limited to illicit drugs, excluding tobacco and alcohol) during their pregnancy.

Study Design

Observational Model: Cohort, Time Perspective: Cross-Sectional

Related Conditions & MeSH terms

• Alcohol-Related Disorders
• Amphetamine-Related Disorders
• Cocaine-Related Disorders
• Disease
• Inhalant Abuse
• Marijuana Abuse
• Neonatal Abstinence Syndrome
• Opioid-Related Disorders
• Pregnancy
• Pregnancy, High-Risk
• Substance Abuse, Intravenous
• Substance-Related Disorders

Locations

Country	Name	City	State
United Kingdom	Trevor Mann Baby Unit, Royal Sussex County Hospital	Brighton

Sponsors (1)

Lead Sponsor	Collaborator
London School of Hygiene and Tropical Medicine

Country where clinical trial is conducted

United Kingdom, 

References & Publications (1)

Sanaullah F, Gillian M, Lavin T. Screening of substance misuse during early pregnancy in Blyth: an anonymous unlinked study. J Obstet Gynaecol. 2006 Apr;26(3):187-90. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Perceptions of conflict between maternal and child-centred approaches	Qualitative data of perceptions of conflict.	4 months	No