Nidey Nichole, Gerdts Grace, Kavouras Michelle, Schiff Davida M
Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA.
SpheraNova, Sitka, AK, USA.
Semin Perinatol. 2025 Feb;49(1):152018. doi: 10.1016/j.semperi.2024.152018. Epub 2024 Dec 5.
Pregnant and parenting people with opioid use disorder commonly experience stigma, or the enactment of negative attitudes, beliefs, and stereotypes, during their pregnancy and at delivery. We will describe four different domains of stigma: self, interpersonal, structural, and policy, and discuss how they intersect to amplify the experiences of shame, anxiety, isolation, lack of trust for birthing people and parents that can contribute to the avoidance of prenatal care and substance use treatment which can impact pregnancy and infant health outcomes. We will review a case example where stigma contributed to poor care, review preferred person-first language to use when talking to and about families impacted by opioid use disorder, and describe emerging interventions to address and mitigate the effects of stigma in the perinatal setting.
患有阿片类物质使用障碍的孕妇和育儿者在孕期及分娩时通常会遭遇耻辱感,即负面态度、观念和刻板印象的表现。我们将描述耻辱感的四个不同领域:自我、人际、结构和政策,并探讨它们如何相互交织,加剧分娩者和父母的羞耻、焦虑、孤立以及缺乏信任的感受,而这些感受可能导致他们回避产前护理和物质使用治疗,进而影响妊娠和婴儿健康结局。我们将回顾一个耻辱感导致护理不佳的案例,审视在与受阿片类物质使用障碍影响的家庭交流及谈论他们时应使用的首选以人为本的语言,并描述在围产期环境中应对和减轻耻辱感影响的新兴干预措施。