Issues of addiction in pregnancy, postpartum, and for the neonate
Written Case Study
“Issues of addiction in pregnancy, postpartum and for the neonate”
As a midwife, you will encounter women and neonates affected by substance use and addiction. Learning about the risk factors, signs, and symptoms of addiction will help to identify women and neonates at risk you may encounter in your clinical practice.
Using a case study approach, the aim is to develop skills in identifying and assessing substance use in pregnant women. Discuss the management of addiction for both the mother and neonate, including care strategies in collaboration with other health professionals.
Ruby is a 29-year-old G1 P0, who presented for antenatal care at 18 weeks. At her first antenatal visit, she disclosed that her partner smoked marijuana and used heroin regularly. At the 32 week visit, it was confirmed that her baby’s growth measured below the expected gestation age. Ruby then admitted that she also had been taking heroin throughout the pregnancy. At that time, Ruby was referred to a substance use clinic, committed to the Methadone program, and ceased her heroin use. By the end of the pregnancy, Ruby’s methadone dose was 80 mg daily. Ruby birthed baby Sarah at 39 weeks by normal SVB. Postpartum, the neonate developed expiratory grunt, nasal flaring, and lung retractions and was transferred to the Special Care nursery for further investigations and assessment. Ruby informed the midwives after the birth that she planned to breastfeed Sarah.
Considering the information in the case study:
1. Using current literature, identify the risks of heroin substance use to the pregnant woman. Discuss the impact heroin use in pregnancy may also have on the fetus.
2. Describe the pathophysiology and effects of heroin withdrawal on the neonate following birth. Using best evidence, identify strategies in caring for the neonate from a midwifery perspective, including assessment and scoring.
Image preview for”discuss the management of addiction for both the mother and neonate, including care strategies in collaboration with other health professionals.”