Compassionate and comprehensive perinatal care : a critical review of perinatal services for women with substance use experiences

Early experiences during conception and pregnancy impact the developing baby. This literature review reveals that maternal health during pregnancy is associated with infant health outcomes and highlights that perinatal substance use negatively impacts maternal and child health outcomes. Despite the awareness of maternal and infant risk, substance use in pregnancy continues. On the one hand, the knowledge revealing the risks associated with perinatal substance use is critical as it highlights the importance of effective intervention for perinatal substance use. On the other hand, this knowledge reinforces dominant discourses villainizing pregnant women with substance use experiences. The literature review considers how perinatal substance use among marginalized women is conceptualized and provides a more contextualized view on substance use. Furthermore, revealing that marginalized women with substance use experiences are often isolated through extreme poverty levels and lack healthy natural or familial support systems. (Heaman et al. 2014). This review draws on feminist theoretical frameworks to examine dominant health and social service systems. The research reveals that many current perinatal services support ethnocentric and neoliberal ideologies which offer western medical approaches. Feminist researchers argue western medical models undervalue the experience and gender-based knowledge of traditional mothering practices and create dichotomies between the mental, physical, and systemic aspects of women's experiences. These fragmented approaches produce inadequate services and create barriers for women to access appropriate care. The findings from this literature review suggest that when substance-using women are provided holistic, gender-based, and trauma-informed care, they experience the healing and support necessary for improved maternal and infant health outcomes.