174127 Building Trust Between Pregnant Substance-Using Women and Prenatal Care Providers in a California County

Monday, October 27, 2008

Sarah Roberts, DrPH , Alcohol Research Group, University of California, Berkeley, Emeryville, CA
Cheri Pies, MSW, DrPH , Family, Maternal and Child Health Programs, Contra Costa Health Services, Martinez, CA
Substance-using pregnant women are over-represented among women who deliver with late, limited, and no prenatal care. Substance-using women who receive adequate prenatal care generally have better birth outcomes than substance-using women who do not receive adequate prenatal care. To engage pregnant substance-using women in prenatal care, the Contra Costa Family, Maternal, and Child Health Programs recruited pregnant and parenting substance-using women to participate in the creation of a consumer-designed community awareness campaign encouraging substance-using pregnant women to seek prenatal care. Twenty individual interviews and four focus groups were conducted. Participants suggested campaign messages such as: “Talk to us, trust us. You will not be judged.” and “You won't be reported to Child Protective Services.” These suggestions describe a response from providers that differs significantly from what women reported receiving when they attended prenatal care. We realized that before we could offer these welcoming messages, prenatal care providers would need to be able to respond in ways that our campaign promised. This presentation describes the process of creating an initial campaign that provides some information and encouragement to women about prenatal care, but does not make promises about what will happen in prenatal care. It then describes the Bridges to Prenatal Care for Pregnant Substance-Using Women Project, a project that seeks to build trust by preparing the perinatal health care system in our county to work more effectively and knowledgably with substance-using women who fear being judged and fear being reported to Child Protective Services.

Learning Objectives:
1. Recognize provider policies and practices that are barriers to prenatal care for pregnant women who use drugs. 2. Describe challenges in creating a trust-building, consumer-designed community awareness campaign. 3. Identify policy development and systems-change strategies to build trust with pregnant women who use drugs.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted the formative research with the study population and led the process of translating the results into a short and long-term strategy for change.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.