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Conflict Between Maternal Autonomy and Child Health in Substance-use

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT02797990
Recruitment Status : Completed
First Posted : June 14, 2016
Last Update Posted : September 8, 2016
Information provided by (Responsible Party):
London School of Hygiene and Tropical Medicine

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

Condition or disease
Substance-Related Disorders Alcohol-Related Disorders Amphetamine-Related Disorders Inhalant Abuse Cocaine-Related Disorders Opioid-Related Disorders Marijuana Abuse Substance Abuse, Intravenous Neonatal Abstinence Syndrome Pregnancy Pregnancy, High-Risk

Detailed 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.

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Study Type : Observational
Actual Enrollment : 6 participants
Observational Model: Cohort
Time Perspective: Cross-Sectional
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
Study Start Date : May 2016
Actual Primary Completion Date : August 2016
Actual Study Completion Date : September 2016

Resource links provided by the National Library of Medicine

Primary Outcome Measures :
  1. Perceptions of conflict between maternal and child-centred approaches [ Time Frame: 4 months ]
    Qualitative data of perceptions of conflict.

Information from the National Library of Medicine

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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
Healthcare workers may include Specialist Midwives, Obstetricians, Substance Misuse Charge Nurses, Neonatologists and Health Visitors. Women using substances are defined as those who are being seen at the clinic (either due to self-referral, or due to referral by a healthcare worker), at any time during their pregnancy. I have personal experience of working in this clinic, which is run in an NHS hospital on the South Coast of the UK.

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.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT02797990

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United Kingdom
Trevor Mann Baby Unit, Royal Sussex County Hospital
Brighton, United Kingdom, BN2 5BE
Sponsors and Collaborators
London School of Hygiene and Tropical Medicine
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Principal Investigator: Chloe Knox London School of Hygiene and Tropical Medicine

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Responsible Party: London School of Hygiene and Tropical Medicine Identifier: NCT02797990     History of Changes
Other Study ID Numbers: 10890
201264 ( Other Identifier: IRAS Number )
FI0816115 ( Other Identifier: LSHTM Sponsorship Certification Number )
First Posted: June 14, 2016    Key Record Dates
Last Update Posted: September 8, 2016
Last Verified: May 2016
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Keywords provided by London School of Hygiene and Tropical Medicine:

Additional relevant MeSH terms:
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Substance-Related Disorders
Opioid-Related Disorders
Cocaine-Related Disorders
Neonatal Abstinence Syndrome
Alcohol-Related Disorders
Marijuana Abuse
Amphetamine-Related Disorders
Substance Abuse, Intravenous
Inhalant Abuse
Pathologic Processes
Chemically-Induced Disorders
Mental Disorders
Infant, Newborn, Diseases