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Health Care System Response to Prenatal Substance Use: An Exploratory Analysis

NCJ Number
139753
Author(s)
G L Zellman; P D Jacobson; H DuPlessis; M R DiMatteo
Date Published
1992
Length
46 pages
Annotation
In an effort to assess how health care providers and hospitals are responding to the use of illicit substances among pregnant women and the effects of substance exposure on neonates, 17 obstetricians, pediatricians, nurses, administrators, and social workers associated with 5 hospitals in 2 California counties were interviewed.
Abstract
The survey results showed that only one hospital maintained active and ongoing efforts to screen pregnant women for the presence of illicit drugs. In general, hospital policies were incorporated into protocols that hospital staff were expected to follow. Implementation of procedural guidelines were often hampered by various practical concerns and procedural rules. Many of those interviewed did not favor routine toxicology screens on newborns as this would increase the days that infants must remain in the hospital and would impose excess costs on the hospital. The subjects pointed to issues of consent and the patient's right to privacy as disincentives to drug screening. While some respondents felt that the ability to provide appropriate treatment and follow-up would provide a strong incentive for health care providers to test for drug use, none mentioned prevention of poor pregnancy outcome, fetal growth retardation, or other fetal damage as sufficient reasons to promote enhanced screening programs. 2 tables and 43 references