A Rapid Review of Perinatal Healthcare Experiences of Women With Substance Use Disorders
Bibliographic record
Abstract
The primary aim of this rapid review was to synthesize the literature on the healthcare experiences of women with substance use disorders (SUDs) during the prenatal and postnatal periods. The secondary aim was to discuss the implications of the findings, in the context of primary care nurse practitioner (NP) practice. A rapid review was conducted, synthesizing research evidence using abbreviated, systematic review methods to generate evidence in a shorter amount of time. Data sources, MEDLINE (Ovid), CINAHL Full-Text (EBSCO), and PsycINFO (EBSCO), were searched in March 2020. The search strategy was developed for MEDLINE by testing identified terms. Those producing unique results were included in the final search, adapted for each database. Inclusion criteria were primary qualitative studies of prenatal and/or postnatal healthcare experiences from the perspective of women with SUDs, published in English, and available in full-text. Twenty-five articles were included, the majority from the United States of America. Using thematic analysis, five themes were identified: (i) stigma, (ii) involvement with child protective services, (iii) lack of supportive education, (iv) the impact of relationships, and (v) challenges accessing holistic care. Further research is required on the prenatal and postpartum healthcare experiences of women with SUDs in the primary care setting receiving care from an NP. More could be learned from the postpartum experiences of women with SUDs, given that the existing literature focuses on pregnancy, with some attention to the neonatal intensive care unit. Pregnant women with SUDs are over-represented among women who receive suboptimal prenatal and postnatal care. Understanding their healthcare experiences is important for developing strategies to improve access to care, thereby improving health outcomes for both mother and infant. Primary care NPs working with women with SUDs will benefit from this review, to inform their practice when caring for this population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.051 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.019 | 0.020 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.005 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".