Session: From Pregnancy through Early Childhood: Providing Sensitive and Effective Interventions for Mothers with Substance Use Disorders and Their Children (Society for Social Work and Research 24th Annual Conference - Reducing Racial and Economic Inequality)

In 2017, 194,000 pregnant mothers reported using illicit substances, an increase of 8.5% from 6.3% in just one year (National Survey on Drug Use and Health). Mothers with substance use disorders (SUDs) face a variety of challenges, which make parenting difficult. Stigma, histories of trauma, stress, depression, and disrupted neurological reward systems contribute to harsh and insensitive parenting. Harsh and insensitive parenting can disrupt children's development with long-term consequences. Additionally, infants born in active withdrawal are irritable, and face increased difficulties feeding and sleeping. These co-occurring factors create challenges for parenting effectively and place children at greater risk for abuse and neglect.

This symposium includes scholars from four different institutions to explore the impact of SUDs in mothers and their children from pregnancy through early childhood. Systemic problems such as historical, racial, and cultural biases in the opioid epidemic have created racial disparity in rates of abuse and access to treatment (Santoro & Santoro, 2018). These four papers inform and assess services and interventions that are inclusive of diverse populations and cut across the ecological system: prenatal services, parenting interventions that are trauma-and attachment-informed, hospital-based interventions in the Neonatal Intensive Care Unit, and residential SUD and parent-infant mental health programs. The goal of this symposium is to provide recommendations for best practices for interventions for caregivers with SUDs and their young children. The first two papers inform interventions from pregnancy (paper 1) into early childhood (paper 2). Paper 1 is a qualitative examination of prenatal services in the context of SUD from the perspectives of postpartum women and health care providers. Specifically emphasized is the recognition of personhood in the patient-provider relationship during pregnancy and the postpartum period and the importance of nonjudgmental approaches in caring for women with SUDs. Paper 2 quantitatively examines parenting practices among mothers with SUDs that inform their children's development. Parenting stress is identified as an important mediator between maternal and child factors (child trauma, depression, resilience) and developmental outcomes in early childhood (social-emotional development). The last two papers assess interventions and services for mothers at delivery (paper 3) and into early childhood (paper 4). Paper 3 is a multi-level model analysis of the impact of a hospital-based intervention for mothers and infants after delivery. Babywearing results in immediate decreased infant pain and caregiver stress (as measured by heart rate) associated with Neonatal Abstinence Syndrome. Paper 4 is a qualitative analysis of how frontline staff address problematic parenting behaviors in a residential setting, revealing a practice gap in integrated SUD and parent-infant mental health treatment programs.

An expert discussant will synthesize these findings and offer suggestions for how social workers can develop and utilize more effective and sensitive interventions for mothers with SUDs and their infants, within micro to macro settings, to improve maternal and infant health outcomes nationally. This discussion offers some innovative strategies which contribute to addressing the larger grand challenges within social work, including ensuring the healthy development of all youth, closing the health gap, and advancing long and productive lives.