Reflections on Equity and Alcohol Use from BC’s Provincial Perinatal Substance Use Conference

It is important to align our work on alcohol use in pregnancy and prevention of FASD, with the work being done on perinatal substance use overall.

Recently, our team had the opportunity to attend the Provincial Perinatal Substance Use Conference in Richmond, BC. The conference was hosted by BC Women’s Hospital + Health Centre’s Mental Health and Substance Programs and Initiatives, which provides centralized leadership and funding to transform perinatal substance use services to improve health and social outcomes for women and people affected by substance use and their families.

The conference speakers invited reflection on what we bring to the work to support those who use alcohol, other substances and face other health and social challenges in the perinatal period.

Community-based and acute care service providers, clinicians, and researchers shared their work in various settings. Some highlights from different settings are included here.

Acute care

Representatives from Nanaimo Regional General Hospital and those leading the Neonatal Abstinence Syndrome Mother-Baby Care ImprovEmeNT (NASCENT) study in Alberta offered learnings from the implementation of rooming-in care. This approach is designed to keep vulnerable mothers and infants together postpartum in acute care settings, and to support attachment and the neurodevelopment of infants. Additionally, Dr. Cattoni from the Families in Recovery (FIR) unit at BC Women’s Hospital offered information on how acute care providers can support pregnant women with Alcohol Use Disorder with pharmacological interventions while also providing other medical care and connecting them to community-based programming. More information, including clinical guidance for perinatal alcohol use, can be found at helpwithdrinking.ca.  

Holistic community-based care

Hajar Masoud from Atira Women’s Resource Society brought insights from their research on women’s health and safety when women are living in vulnerable housing situations (SROs). She described a holistic view of care in the perinatal period that connects peer support, harm reduction, and systemic change strategies. Several representatives from Indigenous programs, including the YuBe-Yah Clinic in Prince George offered by Carrier Sekani Family Services, described how they were filling gaps in care and addressing inequities in culturally safe ways. They offer a very wide range of medical, social and practical supports , with a focus on supporting autonomy and self-determination of Indigenous families.

A continuum of bed-based support

Organizations such as The Sanctuary in Vancouver and Karis Support Society in Kelowna offer multiple level models of support (stabilization, treatment, transitional housing and aftercare) for women and their children together. These programs are relatively rare but are key to addressing so many barriers facing pregnant women and new mothers with alcohol and other substance use concerns.

Decolonizing perinatal care

Many presentations discussed the unique needs of Indigenous populations and how to integrate cultural learning and support in perinatal programming. One powerful testimonial to the benefits of such support was spoken by Billie-Jean Natrall, who described how the cultural activities and support from Elders at Sheway had made all the difference to her growth and healing.

Tools and resources for action 

New resources to support practice were shared, including:

• Grounding our Practice in Safety and Attachment from BC Association of Pregnancy Outreach Programs

• Attachment & Safety Tasks for Pregnant, Postpartum and Newly Parenting People Who Have Used or are Using Substances 2024 fromBC Association of Pregnancy Outreach Programs

• Perinatal Substance Use and Collaborative Practice a course from the Centre of Excellence for Women’s Health

The Mothering and Opioids booklet, shared again at the conference, remains popular for providing tools for reducing stigma and supporting collaborative practice.

The conference was particularly helpful in how keynote speakers, including Dr. Sara Shahram, sparked reflections on equity, and prompted attendees to consider both our role and our responsibility to get clear about the determinants of equity, and to act effectively to promote it in all our work.