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. 2016 Dec;20(4):51-59.
doi: 10.29063/ajrh2016/v20i4.5.

A Qualitative Study of Substance use during Pregnancy: Implications for Reproductive Healthcare in Western Kenya

Kelly A Yotebieng  1 , Kawango Agot  2 , Grace Rota  3 , Craig R Cohen  4 , Jennifer L Syvertsen  1
Affiliations

A Qualitative Study of Substance use during Pregnancy: Implications for Reproductive Healthcare in Western Kenya

Kelly A Yotebieng et al. Afr J Reprod Health. 2016 Dec.

Abstract
in English, French

Women who use alcohol and drugs are often in their childbearing years, creating a need for integrated substance abuse and reproductive health services. However, our understanding of the social context and drivers of substance use during pregnancy, particularly in developing countries, is limited and largely unaddressed in clinical care. Our qualitative research explored the reproductive health of women of childbearing age who inject drugs and its implications for healthcare in Kisumu, Kenya. We used in-depth, semi-structured qualitative interviews with 17 women who inject drugs to explore reproductive health topics including knowledge, practices, and clinical interactions related to substance use during pregnancy. All but one woman had a prior pregnancy and two were pregnant during our study. Alcohol and drug use was prevalent throughout pregnancy, often described as a coping mechanism for stress. Women received mixed advice from family and social contacts regarding alcohol use during pregnancy, leading to differing perceptions of its health effects. Healthcare providers infrequently screened women for alcohol or drug use. Our analysis highlights the need for culturally appropriate alcohol and drug screening and counseling to be included in integrated reproductive health services in western Kenya.

Les femmes qui consomment de l’alcool et des drogues sont souvent en âge de procréer, ce qui crée un besoin de services intégrés de toxicomanie et de santé de la reproduction. Cependant, notre compréhension du contexte social et des moteurs de la consommation de substances pendant la grossesse, en particulier dans les pays en développement, est limitée et largement ignorée dans les soins cliniques. Notre recherche qualitative a porté sur la santé de la reproduction des femmes en âge de procréer qui s’injectent des drogues et ses implications pour les soins de santé à Kisumu au Kenya. Nous avons utilisé des entrevues qualitatives approfondies et semi-structurées auprès de 17 femmes qui s’injectent de la drogue, afin d’explorer des sujets liés à la santé de la reproduction, y compris les connaissances, les pratiques et les interactions cliniques liées à la consommation de substances pendant la grossesse. Toutes les femmes sauf une ont eu une grossesse avant et deux étaient enceintes pendant notre étude. L’usage d’alcool et de drogues était répandu tout au long de la grossesse, souvent décrit comme un mécanisme d’adaptation pour le stress. Les femmes ont reçu des conseils mitigés des contacts familiaux et sociaux concernant la consommation d’alcool pendant la grossesse, ce qui a donné lieu à des perceptions différentes de ses effets sur la santé. Les prestataires de soins de santé ont rarement fait des dépistages de drogues chez les femmes. Notre analyse souligne la nécessité d’inclure des services de dépistage et de consultation sur l’alcool et les drogues dans les services intégrés de santé de la reproduction dans l’ouest du Kenya.

Keywords: Gender; Kenya; alcohol; injection drug use; pregnancy; reproductive health.

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Conflict of interest statement

Disclosure

No conflicts of interest to declare. The content is solely the responsibility of the authors and does not necessarily represent the views of the funders.

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