Complicating the dominant morality discourse: mothers and fathers’ constructions of substance use during pregnancy and early parenthood

International Journal for Equity in Health

Sinéad Charbonneau¹  Lenora Marcellus⁵  Rachel Phillips³  Samantha Magnus²  Cecilia Benoit⁴ 

[1] Faculty of Law, University of Toronto, #1- 328 Arlington Ave, Toronto M6C2Z9, ON, Canada;School of Public Health and Social Policy, University of Victoria, Victoria V8W2Y2, BC, Canada;Centre for Addictions Research of BC, Centre for Addictions Research of BC, Victoria, Canada;Centre for Addictions Research of BC and Department of Sociology, University of Victoria, Victoria V8W3P5, BC, Canada;School of Nursing, University of Victoria, Victoria V8W-2Y2, BC, Canada

关键词: Harm reduction;    Autonomy;    Abstience;    Social determinants of health;    Parenthood;    Pregnancy;    Substance use;   

Others  :  1223228
DOI  :  10.1186/s12939-015-0206-7

 received in 2015-01-19, accepted in 2015-08-17,  发布年份 2015

【 摘 要 】

Introduction

Consumption of substances is a highly controversial behaviour, with those who do so commonly viewed as deviants, even criminals, or else as out of control addicts. In other work we showed that the use of substances by women who are pregnant or have recently become parents was mainly viewed by health and social care providers as morally wrong. Problematic substance use was framed through the narrow lens of gendered responsibilisation, resulting in women being seen primarily as foetal incubators and primary caregivers of infants.

Methods

In this follow-up paper we examine descriptive and qualitative data from a convenience sample of biological mothers and fathers (N = 34) recruited as part of a larger mixed methods study of the development and early implementation of an integrated primary maternity care program. We present a description of the participants’ backgrounds, family circumstances, health status, and perception of drug-related stigma. This is succeeded by a thematic analysis of their personal views on substance use during both pregnancy and the transition to parenthood.

Results

Our results show that while many mothers and fathers hold abstinence as the ideal during pregnancy and early parenting, they simultaneously recognize the autonomy of women to judge substance use risk for themselves. Participants also call attention to social structural factors that increase/decrease harms associated with such substance use, and present an embodied knowledge of substance use based on their tacit knowledge of wellness and what causes harm.

Conclusions

While these two main discourses brought forward by parents concerning the ideal of abstinence and the autonomy of women are not always reconcilable and are partially a reflection of the dissonance between dominant moral codes regarding motherhood and the lived experiences of people who use substances, service providers who are attuned to these competing discourses are likely to be more effective in their delivery of health and social services for vulnerable families. More holistic and nuanced perspectives of health, substance use, and parenting may generate ethical decision-making practice frameworks that guide providers in meeting and supporting the efforts of mothers and fathers to achieve well-being within their own definitions of problematic substance use.

【 授权许可】

   
2015 Benoit et al.

【 图 表 】

Figure 2.

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