Abstract

The number of women of reproductive age misusing opiates has increased considerably over the last 20 years. Numerous Government and Treatment Agency publications have encouraged maternity and drug treatment services to work in partnership to deliver accessible, effective services.

However, little is known about the incidence of opiate dependency in pregnancy locally and even less is known about the obstetric, neonatal, drug treatment and child safeguarding outcomes. This situation makes it difficult for maternity and drug treatment services to measure the effectiveness of care and limits the development of future services. This audit identified 154 Gateshead opiate dependent women who accessed maternity and/or drug treatment services from 1 January 2004 to 31 December 2010 and addresses previous shortcomings in local data.

The majority of women accessed maternity services before 12 weeks, engaged effectively throughout antenatal period and achieved vaginal delivery at term.

Using the postcode a clear correlation exists between areas of social deprivation and point of referral and it is interesting to note that a number of women shared the same postcode.

Complex family situations were not uncommon and there is a clear correlation between mothers who use opiates and their partner's opiate use. Sisters, cousins, aunts and nieces were identified in the audit demonstrating the increased incidence of opiate use within specific families.

While the majority of babies were discharged from hospital with their babies, safeguarding issues occur frequently in the early years highlighting the long term consequences of parental opiate use for mothers and babies.