NSPN 7200 Module 8 Substance Use in
Pregnancy
What are hazard factors for substance use problems at some point of pregnancy?
O Maternal age (age<25 increases risk)
o Education level
o Socioeconomic status (women living at or below poverty line are at increased risk)
o Concurrent psychiatric disorders (anxiety, eating disorders, depression)
o Trauma history
o Family history of substance use/misuse
What are the impacts of substance use on women during pregnancy?
O Stress
o Lack of involvement in prenatal care
o Increased risk of violence
o Infections
o Lack of social support
o Cardiovascular effects with some substances (cocaine and smoking)
What are different types of trauma?
-single incident trauma
-complex or repetitive trauma
-developmental trauma
-intergenerational trauma
-historical trauma
Define single incident trauma
An unexpected and overwhelming event such as an accident, natural disaster, a SINGLE
EPISODE of abuse or assault, sudden loss or witnessing violence.
Define complex or repetitive trauma
ONGOING ABUSE, domestic violence, war, ongoing betrayal, often being trapped emotionally
and/or physically.
, Define developmental trauma
Exposure to EARLY ONGOING AND REPETITIVE TRAUMA (AS CHILDREN) involving neglect,
sexual abuse or assault, emotional abuse, witnessing violence or death, and/or coercion or
betrayal. This often occurs within the child's care giving system and interferes with healthy
attachment and development.
Define intergenerational trauma
The psychological or emotional effects that can be EXPERIENCED BY PEOPLE WHO LIVE
WITH TRAUMA SURVIVORS. Coping and adaptation patterns developed in response to trauma
can be passed from one generation to the next.
Define historical trauma
Cumulative emotional and psychological wounding over the lifespan and ACROSS
GENERATIONS EMANATING FROM MASSIVE GROUP TRAUMA. The collective trauma are
inflicted by a subjugating, dominant population. Examples of historical trauma include genocide,
colonialism (ex residential schools), slavery, war
What are adverse childhood events (ACE)?
O Studies the connection between adverse childhood experiences and health in adulthood and
drew links to mental health challenges and substance use.
O the WHO estimates that childhood maltreatment is responsible for almost a quarter of the
burden of mental disorders.
O 1 in 5 women have experienced childhood maltreatment.
What is the most important thing to consider when a woman uses substances in pregnancy?
O Why the woman is using substances in the first place ex trauma, violence, neglect, assault
What is harm reduction versus abstinence?
O Harm reduction is a model of care that shifts the focus away from abstinence and instead
focuses on reducing the harm of substance use.
O Harm reduction is evidence-based and aligns with safe, competent, and ethical nursing care.
O Abstinence may be the goal for some and is considered part of harm reduction; however, it is
not the goal of all.
What is perinatal depression?
O A major depressive episode during pregnancy and/or after birth or adoption of a baby.
O Affects 16% of women in the perinatal period.
Pregnancy
What are hazard factors for substance use problems at some point of pregnancy?
O Maternal age (age<25 increases risk)
o Education level
o Socioeconomic status (women living at or below poverty line are at increased risk)
o Concurrent psychiatric disorders (anxiety, eating disorders, depression)
o Trauma history
o Family history of substance use/misuse
What are the impacts of substance use on women during pregnancy?
O Stress
o Lack of involvement in prenatal care
o Increased risk of violence
o Infections
o Lack of social support
o Cardiovascular effects with some substances (cocaine and smoking)
What are different types of trauma?
-single incident trauma
-complex or repetitive trauma
-developmental trauma
-intergenerational trauma
-historical trauma
Define single incident trauma
An unexpected and overwhelming event such as an accident, natural disaster, a SINGLE
EPISODE of abuse or assault, sudden loss or witnessing violence.
Define complex or repetitive trauma
ONGOING ABUSE, domestic violence, war, ongoing betrayal, often being trapped emotionally
and/or physically.
, Define developmental trauma
Exposure to EARLY ONGOING AND REPETITIVE TRAUMA (AS CHILDREN) involving neglect,
sexual abuse or assault, emotional abuse, witnessing violence or death, and/or coercion or
betrayal. This often occurs within the child's care giving system and interferes with healthy
attachment and development.
Define intergenerational trauma
The psychological or emotional effects that can be EXPERIENCED BY PEOPLE WHO LIVE
WITH TRAUMA SURVIVORS. Coping and adaptation patterns developed in response to trauma
can be passed from one generation to the next.
Define historical trauma
Cumulative emotional and psychological wounding over the lifespan and ACROSS
GENERATIONS EMANATING FROM MASSIVE GROUP TRAUMA. The collective trauma are
inflicted by a subjugating, dominant population. Examples of historical trauma include genocide,
colonialism (ex residential schools), slavery, war
What are adverse childhood events (ACE)?
O Studies the connection between adverse childhood experiences and health in adulthood and
drew links to mental health challenges and substance use.
O the WHO estimates that childhood maltreatment is responsible for almost a quarter of the
burden of mental disorders.
O 1 in 5 women have experienced childhood maltreatment.
What is the most important thing to consider when a woman uses substances in pregnancy?
O Why the woman is using substances in the first place ex trauma, violence, neglect, assault
What is harm reduction versus abstinence?
O Harm reduction is a model of care that shifts the focus away from abstinence and instead
focuses on reducing the harm of substance use.
O Harm reduction is evidence-based and aligns with safe, competent, and ethical nursing care.
O Abstinence may be the goal for some and is considered part of harm reduction; however, it is
not the goal of all.
What is perinatal depression?
O A major depressive episode during pregnancy and/or after birth or adoption of a baby.
O Affects 16% of women in the perinatal period.
