Pregnancy and drugs: what healthcare do women want?

Abstract Background The use of psychoactive substances has increased among women, surrounded by discrimination, frustrations, and violations of rights. This theme is on the debate agenda of the current policies on women’s mental health in Brazil, immersed in tensions facing new public funding proposals. Objective The aim of this study was to describe, from the perspective of women users of psychoactive substances, the characteristics desired for prenatal care. Method In a university extension activity articulated to a Brazilian formative program called PET-Networks of Care, this exploratory, qualitative, field study was conducted with 19 women users of psychoactive substances through the application of a questionnaire and a semi-structured interview. Results The results revealed dissonance between the health cared received and the one expected. The latter is in line with a dialogical and integral perspective, as planned by the SUS. Women’s reports show the presence of social stigma, which is a challenge to be faced. Conclusion The health care for pregnant women users of psychoactive substances needs to assume a dialogic, integral, and multifaceted perspective, and the fight against social stigma becomes urgent. Further studies in this area are suggested.

研究背景：在遭受歧视、挫折与权利侵害的女性群体中，精神活性物质（psychoactive substances）的使用比例有所上升。该议题已被纳入巴西当前女性心理健康政策的辩论议程，且正身处新公共资助提案所引发的多重紧张局势之中。
研究目的：本研究旨在从精神活性物质女性使用者的视角出发，阐明她们对产前护理的期望特征。
研究方法：本研究为探索性质性田野研究，依托与巴西养成项目「护理伙伴网络（PET-Networks of Care）」联动的大学推广活动，通过问卷调查与半结构化访谈的方式，对19名精神活性物质女性使用者开展调研。
研究结果：结果显示，女性使用者实际获得的医疗照护与她们的预期存在显著分歧。后者契合巴西统一卫生系统（SUS）所规划的对话式、整体性照护理念。女性受访者的反馈显示，社会污名（social stigma）的广泛存在是一项亟待攻克的挑战。
研究结论：针对精神活性物质使用孕妇的医疗照护，需秉持对话式、整体性且多维度的照护视角，而对抗社会污名的行动已刻不容缓。本研究建议后续在该领域开展更多相关研究。