Programs and practices that support pregnant people who use drugs’ access to sexual and reproductive health care in Canada: a scoping review
-
Published:2024-01-22
Issue:1
Volume:24
Page:
-
ISSN:1471-2393
-
Container-title:BMC Pregnancy and Childbirth
-
language:en
-
Short-container-title:BMC Pregnancy Childbirth
Author:
Mathias Holly,Foster Lesley Ann,Rushton Ashleigh
Abstract
Abstract
Background
Pregnant people who use unregulated drugs (PPWUD) are at high risk of health complications yet experience a range of barriers to sexual and reproductive health care. Given that improving maternal health and access to reproductive health care are key targets underpinning the Sustainable Development Goals (SDG), there is an urgent need to improve access to appropriate supports and services for this population. Little is known about what programs and practices exist to support PPWUD’s access to sexual and reproductive health care. This scoping review aimed to identify the available literature on these programs and practices in Canada.
Methods
A scoping review was conducted using JBI methodology and reported using PRISMA guidelines. Scholarly databases and grey literature sources were searched to identify literature published between 2016–2023 in English or French that discussed, defined, conceptualised, or evaluated programs and practices that support PPWUD’s access to sexual and reproductive health care in Canada. Identified literature was screened using Covidence. Data were extracted from included texts, then analysed descriptively. Frequencies and key concepts were reported.
Results
A total of 71 articles were included, most of which were grey literature. Of the total, 46 unique programs were identified, as well as several useful practices. Most programs were in urban centres in Western Canada, and most programs offered holistic ‘wrap-around services.’ Several programs delivered these services on-site or as ‘drop-in’ programs with the support of staff with lived/living experience of substance use. Most frequent program outcomes included keeping parents and children together, improving connection to other services, and reducing substance use harms. Noted helpful practices included non-judgmental care and the use of harm-reduction strategies.
Conclusions
Several programs and practices that support PPWUD exist in Canada, though few focus exclusively on sexual and reproductive health. There remain opportunities to improve access to programs, including expanding geographic availability and range of services. The review has clinical application by providing an overview of available programs that may support clinicians in identifying services for PPWUD. Future research should consider client perspectives and experiences of these programs.
Review registration number
Open Science Framework https://osf.io/5y64j.
Funder
Social Sciences and Humanities Research Council of Canada
Pierre Elliott Trudeau Foundation
Canadian Institutes of Health Research
Publisher
Springer Science and Business Media LLC
Subject
Obstetrics and Gynecology
Reference152 articles.
1. United Nations Office on Drugs and Crime, editors. World drug report, 2022. New York: United Nations; 2022. Available from https://www.unodc.org/res/wdr2022/MS/WDR22_Booklet_2.pdf. [Cited 2023 July 19].
2. Mburu G, Ayon S, Mahinda S, Kaveh K. Determinants of women’s drug use during pregnancy: Perspectives from a qualitative study. Matern Child Health J. 2020;24(9):1170–8. https://doi.org/10.1007/s10995-020-02910-w. [Cited 2023 Apr 14].
3. Public Health Agency of Canada. Opioid and stimulant related harms in Canada. 2023. Available from: https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/. [Cited 2023 July 22].
4. Paradis D. Treaty 6 Chiefs declare state of emergency over opioid deaths. APTN. 2023. Available from: https://www.aptnnews.ca/national-news/treaty-6-chiefs-declare-state-of-emergency/. [Cited 2023 July 29].
5. Government of British Columbia. Provincial health officer declares public health emergency. Government of British Columbia. 2016. Available from https://news.gov.bc.ca/releases/2016HLTH0026-000568. [Cited 2023 July 30].