Motivational Interviewing seems benefits for clients to reduce prenatal
alcohol use. It has same effects of in-person interviewing. Some other methods
are counseling, screening methods, and increase the knowledge about the consequences
of substance abuse through multimedia and other educational materials.
Behavioral therapy is an effective method for smoking cessation. Most of the
randomized clinical trial studies not recommending pharmacological
interventions due to the safety and efficacy of pregnant and postpartum stages.
Nicotine replacement therapy has limited effect on the rates of abstinence. The
most successful management for substance abuse is contingency management with
financial incentives. Breast feeding is another non-pharmacological
intervention. It helps mothers to rethink about to continue smoking because it
adversely affect their babies. Therefore, promotion of breastfeeding is helpful
to prevent or delay postpartum relapse. Another important benefit is during
lactation oxytocin hormone is producing largely it helps to reduces stress which
is one cause of addiction. Moreover, oxytocin is helpful for cognitive and
motor development for an infant, and increase skin-to-skin intimacy between mom
and baby, through this we can protect the fetus from the development of
addictive and other problematic behaviours. Frequent visits during pregnancy
will helpful for the physician to identify any relapse will happen in-between.
Collect urine sample on each visit too. Rehabilitation services, frequent
educational programs, individual and family counseling also help her to
withdraw from substance use.
On the other hand, negative attitudes of HCP’s
and their response will cause individual withdraw from seeking medical attention.
So here our team involved jack in her
treatment plan according to her needs, made a therapeutic relationship with her
and provided special care referred her to another resource for detailed examination.
Participation of multidisciplinary team is better than the individual plan of
care. Everyone’s decision should be supportive and non-judgemental to her. Regular meeting and discussion with her will
give more security to her thus the prognosis will be easier than formal visits.
The role of the nurse is very important. They are the first person in contact
with women who are using the substance. So, the initial relationship is very
important. While taking all the medical and social history they can provide
adequate information regarding various facilities available in the community.
Provide enough information regarding next appointment or and other referral
they needed for this will helpful for the client to develop a more therapeutic
relationship with midwife/HCP.