Transcript ENHANCING THE REPRODUCTIVE HEALTH OF DRUG USERS

PREVENTING FUTURE
PROBLEMS
SCOTTISH DRUGS FORUM
28th November 2005
Intervention at Birth
Mary Hepburn
Princess Royal Maternity
Glasgow
DRUG USERS AS PARENTS
• Drug use is not incompatible with
adequate parenting
• Women should be helped to have
pregnancies if and/or when they choose
• Services should help women protect
and control their fertility
DRUG USE AND PREGNANCY
Medical outcomes
• Increased maternal mortality and
morbidity
• Increased perinatal mortality and
morbidity
• Increased ill health in adulthood
DRUG USE AND PREGNANCY
Social outcomes
• Parenting difficulties
• Separation of mother and baby
• Child protection issues
DRUG USE AND FERTILITY
• Drug use can reduce fertility directly and
indirectly
• Menstruation is not an indicator of fertility
• Risk of sexually transmitted infections
• Methadone increases fertility
• Stabilisation of lifestyle increases fertility
• Women who do not want to become
pregnant need effective contraception
PLANNING OF PREGNANCIES
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Stability of drug use
Stability of lifestyle
Diet
Cytology screening
Infection screening
Folic acid supplementation
Postnatal contraception
DRUGS AND CONTRACEPTION
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Effective
Usable
Safe
Long acting
Reversible
DRUG USE AND INFECTION
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BBV screening
STI screening
Cytology screening
Immunisation vs HBV / HAV
Follow up of babies
SERVICE DESIGN AND DELIVERY
• Management: address poverty as a whole
• Reproductive healthcare: an integral part of all
drug treatment services
• Maternity care: multidisciplinary, embedded in
maternity services
• Service design: continuity of reproductive
healthcare
• Service delivery: accessible by any route
including self referral
• Follow up: family support in the community