Transcript Specialist Midwife in Substance Misuse

Substance Misuse
in
Pregnancy
Angela Geraghty - Specialist Midwife
Tel: (Office) 0116 258 5990 (Mobile) 07966 558286
(Fax) 0116 258 7262
ACCESS & AWARENESS
• Women need to be able to access the
services
• Increase awareness of services
• Take care into the community
• Assertive Outreach – do not wait for
them to come to us!
• Drug/Alcohol misusers are known not to
access general health services until late
pregnancy (Drug misuse and dependence 2007)
• Thus increases risk to both Mother and
Baby.
• Drug treatment programmes can enable
better outcomes during pregnancy,
childbirth and infant development.
• Regardless of continuing illicit drug or
alcohol use.
• By opportunistic care and health
promotion during engagement.
• There is a reduced window of
opportunity to engage these women and
therefore it is important to take the care
to them in order to maintain their
involvement.
• The Specialist Midwife is a key person
in linking all services to provide support,
advice and care for both mother and
baby
Multi-Disciplinary Approach
• Involvement by all agencies is vital.
Offering support with
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Financial issues
Psychological issues
Social issues
Domestic issues.
• Comprehensive, direct and easy referral
process is vital for continuity of care
• Availability of a self referral process
Clinic Development
• Specialist Clinic – Alternate Tuesdays pm
involving Cons, CDT, SW, Specialist
Midwife and other co-opted members as
required.
• Midwifery Led Clinics:
• Paget House
• Cameron Stastny
• Criminal Justice Integration Team, Nelson Street
New Guidelines & Protocols
• New Guidelines on caring for this client group
• New Referral process to Specialist Midwife for
clients identified by CMW at booking appt.
• Clear protocol for care and identification of client
needs & referral to specialist clinic.
• Clients engaged in care can receive shared care
between CMW and Specialist Midwife/Clinic
• Clients difficult to engage will be caseloaded by
the Specialist Midwife.
Further Development of Services
• Training for staff in substance misuse
• Development of a screening tool for
early identification of vulnerable women
to enable them early support and
access to services.
• Comprehensive multi-disciplinary care
plans to ensure a seamless service
• References
• Drug Misuse and dependence – UK guidelines on clinical
management. DoH 2007
• Drugs: protecting families and communities – The 2008 drug
strategy. HM Government 2009
• Getting Our Priorities Right. Scottish Executive. 2003
• Hidden Harm. Responding to the needs of children of problem
drug users. Home Office 2003
• The Children's Act 1989. HMSO
• Antenatal Care. Routine care for healthy pregnant women.
National Institute of Clinical Excellence. 2003
• Working Together to Safeguard Children. DoH 1999
• Medications in mother's milk. T Hale, Pharmasoft publishing
2004
• RCOG green top guidance, statement number 5 – alcohol
consumption and the outcomes of pregnancy, March 2006
• Substance Misuse in Pregnancy, A resource book for
Professionals. Drugscope 2005
Street Names
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Benzo’s
Brown/Smack
Snow/White
Bubbles/Meow
Uppers/Speed
Blow/Skunk
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Tranquilisers
Heroin
Cocaine
Mephedrone/MCAT
Amphetamines
Cannabis