Men's influence of maternal substance use before, during, and after pregnancy: A qualitative study of men with criminal-legal involvement.

Jennifer K Bello, Andrew R Wong, Michaela Piechowski, Lynn Chen, Hope Stratman, Lisa A Jaegers
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Abstract

Background: While the adverse effects of substance use during pregnancy are well-established, the impact men with criminal-legal involvement who use substances have on their partner's substance-using behaviors is not well characterized. We aim to understand men's experiences and perspectives about how their substance use impacts romantic partner substance use in the preconception period, before a potential or actual pregnancy.

Methods: We conducted semi-structured interviews with men residing in a transition center in the Midwestern US with a substance use disorder (SUD) who partnered with women. Interview questions were informed by the Health Belief Model (HBM) and included questions about perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy in relation to substance use and pregnancy. Participants were asked about desired SUD interventions. Transcripts were analyzed using a modified grounded theory approach.

Findings: Thirty participants were interviewed (mean age=37, SD=10.3). Major themes were mapped onto HBM constructs: (1) Partners did not consider the chance of pregnancy while using together; (2) using together can escalate use before/during pregnancy; (3) quitting can strengthen relationships; (4) lack of preconception health knowledge inhibits quitting; (5) having a pregnant partner may promote quitting; and (6) knowledge of potential negative outcomes increases confidence in quitting.

Conclusion: Men in carceral settings face multi-factorial barriers to substance use cessation and have differing perspectives on the impact of their use on their partner in relation to potential or actual pregnancy. Clinicians should consider interpersonal relationship factors that may impede or promote substance use when caring for people with SUD.

背景:虽然怀孕期间使用药物的不良影响已得到证实,但涉及刑事法律的男性使用药物对其伴侣使用药物行为的影响却没有得到很好的描述。我们旨在了解男性在潜在或实际怀孕前的孕前阶段使用药物如何影响浪漫伴侣使用药物的经历和观点:我们对居住在美国中西部过渡中心、患有药物使用障碍(SUD)并与女性有伴侣关系的男性进行了半结构化访谈。访谈问题参考了健康信念模型(HBM),包括与药物使用和怀孕相关的易感性、严重性、益处、障碍、行动提示和自我效能等问题。参与者还被问及希望采取的 SUD 干预措施。采用改良的基础理论方法对记录誊本进行了分析:对 30 名参与者进行了访谈(平均年龄=37 岁,SD=10.3)。主要的主题被映射到 HBM 结构上:(1)伴侣在共同使用毒品时没有考虑怀孕的可能性;(2)共同使用毒品会使怀孕前/怀孕期间的吸毒行为升级;(3)戒毒可以加强人际关系;(4)缺乏孕前健康知识会阻碍戒毒;(5)伴侣怀孕会促进戒毒;(6)对潜在负面结果的了解会增加戒毒的信心:结论:囚禁环境中的男性在戒除药物使用方面面临多种因素的阻碍,他们对使用药物对其伴侣可能或实际怀孕的影响有不同的看法。临床医生在照顾药物滥用者时,应考虑可能阻碍或促进药物滥用的人际关系因素。
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