Investigating Surveillance Experiences Among Pregnant Women in Drug Treatment

Recent research has delved into the complex experiences of pregnant women who are either using drugs or undergoing treatment for substance dependence. The study, conducted by a team from King's College London, in collaboration with researchers from the University of Stirling, University of Huddersfield, and Homerton Health Care, aimed to understand the care pathways and the emotional landscape faced by these women.

Published in The British Journal of Social Work, this investigation utilized longitudinal qualitative methods to explore the prenatal care experiences of thirty-six women across various regions in England and Scotland. The participants, many of whom had previously faced the traumatic experience of having their children removed by social services, shared their anxieties regarding potential referrals to social work and the implications for their pregnancies.

The findings revealed significant concerns surrounding the surveillance these women face during their pregnancies. Participants expressed feelings of guilt and shame related to their drug use, alongside fears regarding the impact of their substance use on their unborn children. The research highlighted that many women felt overwhelmed by the multi-agency monitoring they were subjected to, which was often perceived as intrusive and distressing.

Dr. Polly Radcliffe, a Senior Research Fellow at King's IoPPN and the first author of the study, noted the prevalent anxiety among women who had previously lost custody of their children. This anxiety often led to a concealment of their substance use, as the fear of social services intervention outweighed the potential benefits of seeking treatment. The study critiques the existing multi-agency approaches that, while intended to safeguard children, may inadvertently perpetuate trauma among vulnerable women.

Despite ongoing discussions in the field about the necessity of trauma-informed care for this demographic, the study found that the current practices often fail to meet these needs effectively. Many women reported a lack of supportive and understanding approaches from healthcare providers, contributing to a sense of marginalization.

The implications of these findings are far-reaching. The research suggests that service providers must adopt strategies that are more attuned to the unique challenges these women face. By addressing their fears and providing compassionate and responsive care, it may be possible to foster better outcomes for both mothers and their babies. Moreover, to disseminate the insights gained from this research, the team has collaborated with Outside Edge Theatre Company to create a theatrical piece that aims to raise awareness and encourage dialogue among midwifery and social work students and practitioners. Performances are scheduled to take place in London and Sheffield in December 2026.

This study represents a crucial step towards understanding and improving the experiences of pregnant women in drug treatment, advocating for a shift in the way services interact with this vulnerable population.