Other Titles

PechaKucha Presentation

Abstract

Purpose: To build a partnership with Drug Liasion Midwife leaders of the Vulnerability in Pregnancy (VIP) program, leading to improved perinatal substance use care in Missoula County, Montana.

Background: Perinatal substance use is a global maternal health concern leading to increased maternal and infant morbidity and mortality. In the United States (US) the incidence of neonatal abstinence syndrome (NAS) increased from 1.6 to 8.8/1,000 live births between 2004 and 2016 and neonatal opioid withdrawal syndrome (NOWS) increased from 1.2 to 8.8/1,000 live births between 2000 and 2016 (Kameg, 2021; Kramlich et al., 2018; Patrick et al., 2020). In 2020 in Missoula County 41.3% of newborns tested for substance exposure tested positive, an increase of 28.2% from the previous year (Semple, 2021). It is estimated that only 9% of people who use substances while pregnant receive prenatal care, often due to fear of stigma and punitive recourse (Lipsett et al., 2023; Gulbransen et al., 2024; Kameg, 2021; Lipsett et al., 2023).

Best Practice: Scotland has made a concentrated effort to address perinatal substance use through collaborative and integrated care. In 1999 a community midwife recognized an increase in the incidence of NAS and heroin use among deliveries at her local hospital and worked to create programmatic change, ultimately leading to the VIP project (NHS Fife, 2024; NHS Scotland, 2021). To build collaboration and determine ways to replicate this program in Montana, the researcher traveled to Scotland for an immersive experience with the VIP team.

Learning Outcomes: Through this immersive experience the researcher learned ways to improve trauma informed care practices through education, discovered innovative practices that increase interprofessional collaboration, and increased knowledge surrounding the care of people who use substances while pregnant. From the practices observed and the relationships made, a preliminary perinatal substance use interprofessional model will be created to pilot in Missoula, Montana.

Conclusions: As the United States continues to face declining maternal health outcomes it is imperative that nursing practice follows an alternative approach to caring for this vulnerable population. Continued collaboration with the VIP program following the Global Learning to Advance Health Equity framework to guide this process may improve the care of birthing people and their infants in Missoula County (Shin et al., 2023).

Notes

This project focuses on building a global collaboration with specialist midwives in Scotland in order to improve perinatal health care in Montana.

Description

References:

NHS Fife. Enhanced midwifery support services. Retrieved August 27, 2024 from https://www.nhsfife.org/services/all-services/maternity/antenatal-care/enhanced-midwifery-support-services/

Gulbransen, K., Thiessen, K., Ford, N., Phillips Beck, W., Watson, H., & Gregory, P. (2024). Interprofessional Care Models for Pregnant and Early-Parenting Persons Who Use Substances: A Scoping Review. International Journal of Integrated Care, 24(2), 24. https://doi.org/10.5334/ijic.7589

Kameg, B. N. (2021). Modernizing Perinatal Substance Use Management. Policy, Politics, & Nursing Practice, 22(2), 146-155. https://doi.org/10.1177/1527154420981945

Kramlich, D., Kronk, R., Marcellus, L., Colbert, A., & Jakub, K. (2018). Rural Postpartum Women With Substance Use Disorders. Qualitative Health Research, 28(9), 1449-1461. https://doi.org/10.1177/1049732318765720

Leggate, J. (2008). Improving pregnancy outcomes: Mothers and substance misuse. British Journal of Midwifery, 16(3), 160-165. https://doi.org/10.12968/bjom.2008.16.3.28697

Lipsett, M., Wyant-Stein, K., Mendes, S., Berger, E., Berkman, E. T., Terplan, M., & Cioffi, C. C. (2023). Addressing stigma within the dissemination of research products to improve quality of care for pregnant and parenting people affected by substance use disorder [Policy and Practice Reviews]. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1199661

Patrick, S. W., Barfield, W. D., & Poindexter, B. B. (2020). Neonatal Opioid Withdrawal Syndrome. Pediatrics (Evanston), 146(5), e2020029074. https://doi.org/10.1542/peds.2020-029074

NHS Scotland, Perinatal Mental Health Network Scotland. (2021). Supporting women, reducing harm: Review of services for substance-using women and their infants in pregnancy and the postnatal period. National Health Service Scotland Retrieved from https://www.nn.nhs.scot/pmhn//wp-content/uploads/sites/11/2021/09/SUPPORTING-WOMEN-REDUCING-HARM-Report-V1.pdf

Semple, A., Morton, S., Garber, S., Carde, H., Naylor, L., Galloup, D., Campbell, D. (2021). Missoula county perinatal substance use network information and inital report. Retrieved from https://www.healthystartmissoula.org/_files/ugd/d52276_621782428630407f8663ad5cb7f1e48d.pdf

Shin, S. S., Shah, A., North-Kabore, J., Rowthorn, V., Fiori, K. P., Dudding, R., Plum, R. A., Parke, D. M., George, C., Thomas, S., Pinkett, R., Porter, K. M. P., Sirois, A., Cordeiro, V., & Ogbolu, Y. (2023). Global Learning for Health Equity: A Survey of Five Global Learning Sites in the United States. Community Health Equity Research & Policy, 2752535x231210046. https://doi.org/10.1177/2752535x231210046

Author Details

Marcy Nell Hanson, PhD, MN, RN; Margaret Lawson, NP, RM, BA, RGN; Hazel Sinclair, MSc, BMid, RM

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Perinatal Substance Use, Global Maternal Health Concerns, Interprofessional and Global Collaborations, Montana, USA, Scotland

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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From Scotland to Montana: A Global Collaboration

Seattle, Washington, USA

Purpose: To build a partnership with Drug Liasion Midwife leaders of the Vulnerability in Pregnancy (VIP) program, leading to improved perinatal substance use care in Missoula County, Montana.

Background: Perinatal substance use is a global maternal health concern leading to increased maternal and infant morbidity and mortality. In the United States (US) the incidence of neonatal abstinence syndrome (NAS) increased from 1.6 to 8.8/1,000 live births between 2004 and 2016 and neonatal opioid withdrawal syndrome (NOWS) increased from 1.2 to 8.8/1,000 live births between 2000 and 2016 (Kameg, 2021; Kramlich et al., 2018; Patrick et al., 2020). In 2020 in Missoula County 41.3% of newborns tested for substance exposure tested positive, an increase of 28.2% from the previous year (Semple, 2021). It is estimated that only 9% of people who use substances while pregnant receive prenatal care, often due to fear of stigma and punitive recourse (Lipsett et al., 2023; Gulbransen et al., 2024; Kameg, 2021; Lipsett et al., 2023).

Best Practice: Scotland has made a concentrated effort to address perinatal substance use through collaborative and integrated care. In 1999 a community midwife recognized an increase in the incidence of NAS and heroin use among deliveries at her local hospital and worked to create programmatic change, ultimately leading to the VIP project (NHS Fife, 2024; NHS Scotland, 2021). To build collaboration and determine ways to replicate this program in Montana, the researcher traveled to Scotland for an immersive experience with the VIP team.

Learning Outcomes: Through this immersive experience the researcher learned ways to improve trauma informed care practices through education, discovered innovative practices that increase interprofessional collaboration, and increased knowledge surrounding the care of people who use substances while pregnant. From the practices observed and the relationships made, a preliminary perinatal substance use interprofessional model will be created to pilot in Missoula, Montana.

Conclusions: As the United States continues to face declining maternal health outcomes it is imperative that nursing practice follows an alternative approach to caring for this vulnerable population. Continued collaboration with the VIP program following the Global Learning to Advance Health Equity framework to guide this process may improve the care of birthing people and their infants in Missoula County (Shin et al., 2023).