Obstetrician-Gynecologists' referral practices for substance use during pregnancy

Abstract

Objectives: Substance use during pregnancy is a major health concern. Ob-gyns are in a unique position to encourage patients to receive treatment. Providing appropriate referrals is crucial to providing patients with the care they need, for the health of the mother and child. This study seeks to understand how and where pregnant patients are referred for substance use, and if these referrals are dependent on type of drug or other factors. Understanding provider practices and beliefs regarding substance use referral will help to better educate ob-gyns on how to care for these patients. Methods: An online questionnaire was disseminated to a random sample of American College of Obstetricians and Gynecologists (ACOG) members asking about practice patterns for pregnant patients with substance use. Results: Most physicians inquire about substance use from their patients as part of the prenatal appointment. However, marijuana and illegal drugs are asked about less frequently than tobacco and alcohol, and referrals are not always offered. The inconsistency of referrals is primarily due to patient refusal and the lack of referral resources. When patients are referred, it is typically to MFMs or addiction specialists; most physicians report follow up on the referral at their next appointments. Conclusions: Providers may not be receiving adequate training to manage marijuana or other illicit drug use among pregnant women. Given increasing marijuana use and prescription drug misuse over the past few years, it is important for physicians to be aware of screening and referral recommendations for these substances.