Background

This study examined knowledge, attitudes and opinions regarding alcohol, tobacco, and other drug (ATOD) use during pregnancy among women enrolled in drug treatment centers. It also assessed the educational and screening practices of health care professionals who care for women of child-bearing age in Utah.

Methods

The assessment of ATOD use was based on a convenience sample of women who were enrolled in drug treatment centers in Utah. The sample (n = 60) was surveyed by trained research team members. The assessment of screening practices of physicians and other medical professionals (n = 350) who deal with women’s obstetric and gynecological conditions was conducted via an online survey. An in-depth interview with seven of the professionals was also conducted.

Results

Most women surveyed (72%) reported that they would follow the advice of their health care provider regarding the use of alcohol, tobacco and other drugs (ATOD). Other sources of information (e.g. TV, Internet and radio) were less trusted. The women also indicated that a major barrier to disclosing an ATOD use was fear of negative consequences, both legal and social. Analysis of data from the professionals surveyed indicated that while most do some screening, there is a significant difference in ATOD screening practices for pregnant women and for women who are of childbearing age but not pregnant. Further, while nearly all professionals reported educating women who came to their clinic, fewer than 35% indicated using written educational materials. Lack of time was indicated as the primary barrier to proper screening and education of women in health care clinics.

Conclusion

Women who have been enrolled in treatment centers for ATOD addictions are fearful of the negative legal and social repercussions as a result of their ATOD use and hence do not consistently seek prenatal care. However, when information is given, most women are willing to comply with the recommendations of their health care providers. Providers are also very interested in quality patient care, but indicate that lack of time does not allow adequate one-on-one time with each patient. Screening and educational practices are performed in most offices, but both the timing of the screening and approach to patient education may not be sufficient to ensure optimal outcomes.