Martinez Noelle G, Kramer Camille T, Hayes Crystal M, Motlagh-Harvey Audry S, Tikofsky Shira Y, Sufrin Carolyn B
Division of Addiction Medicine, Johns Hopkins University School of Medicine Baltimore, Maryland, USA.
Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Soc Work (Lond). 2025 May;25(3):279-300. doi: 10.1177/14680173241283393. Epub 2024 Oct 15.
Black women who use substances face significant barriers to accessing resources and parenting their children, largely as a result of interactions with the criminal legal, child welfare, and healthcare systems. While extensive literature has demonstrated how structural racism and punitive policy approaches underpin the operation and impact of these systems, minimal attention has been paid to how social workers approach child, maternal, and family well-being when interacting with clients who use substances and have been incarcerated. To address this gap, we conducted semi-structured qualitative interviews with 19 social workers practicing in jail/prison, community, and hospital settings across the United States.
Interviews identified the cyclical and intergenerational nature of harms perpetuated through criminal legal, child welfare, and healthcare systems. Participants described structural racism, inadequate resources (i.e., housing), and previous criminal legal and child welfare involvement as compounding barriers to an individual's ability to parent and maintain recovery, particularly among Black families. Participants described the pervasiveness of structural racism but did not perceive themselves as active participants in perpetuating racist and oppressive structures.
Social workers engage with Black pregnant women who use substances across diverse practice settings and as such have the potential to both contribute to systemic harms and to champion interventions that target the root causes of inequity. Study findings support structural interventions that dismantle punitive systems and re-center the needs of Black communities, thereby supporting Black mothers in their fundamental right to parent their children.
使用毒品的黑人女性在获取资源和养育子女方面面临重大障碍,这主要是由于与刑事法律、儿童福利和医疗保健系统的互动所致。虽然大量文献表明结构性种族主义和惩罚性政策方法如何支撑这些系统的运作和影响,但对于社会工作者在与使用毒品且曾被监禁的客户互动时如何处理儿童、孕产妇和家庭福祉问题,却很少有人关注。为了填补这一空白,我们对美国各地在监狱/看守所、社区和医院环境中执业的19名社会工作者进行了半结构化定性访谈。
访谈确定了通过刑事法律、儿童福利和医疗保健系统延续的伤害的循环性和代际性。参与者描述了结构性种族主义、资源不足(如住房)以及以前涉及刑事法律和儿童福利的情况,这些都是个人养育子女和维持戒毒能力的复合障碍,尤其是在黑人家庭中。参与者描述了结构性种族主义的普遍性,但并不认为自己是延续种族主义和压迫性结构的积极参与者。
社会工作者在不同的实践环境中与使用毒品的黑人孕妇打交道,因此有可能既助长系统性伤害,也支持针对不平等根源的干预措施。研究结果支持结构性干预措施,这些措施拆除惩罚性系统,重新以黑人社区的需求为中心,从而支持黑人母亲养育子女的基本权利。