Mother vs. Child? Healthcare Professionals’ Perceptions of Maternal-Fetal Conflict in Antenatal Substance Use

Knox C*
Brighton and Sussex Medical School*
Substance use in pregnancy is a common issue in the UK, affecting maternal, fetal and child health. Healthcare professionals practicing in this field are exposed to contrasting child-centred and woman-centred discourses. This study explores the model of the maternal-fetal relationship used by healthcare workers, and their perceptions of maternal-fetal conflict in antenatal substance use.
Semi-structured interviews were conducted with six healthcare professionals working within a hospital-based clinic on the south coat of the UK. Framework analysis was conducted, applying Marcellus’ four models of the maternal-fetal relationship: Woman-Centred, Fetus-Centred, Mother and Fetus as Distinct Individuals and Pregnant Embodiment.
Healthcare workers providing care for women using substances in pregnancy experience conflict from numerous sources, forcing them to continually construct and adjust their model of the maternal-fetal relationship. Alcohol was perceived as distinct from the other substances used by pregnant women. Whilst harm reduction approaches were advocated in the case of illegal substances, total abstinence from alcohol was supported by participants.
To provide supportive care to women using substances in pregnancy, healthcare workers must negotiate the contrasting discourses of policy and practice. Further research is required to explore the distinct conceptualisation of alcohol in pregnancy among healthcare staff.
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