While the perinatal period presents unique risks for those who are substance dependent and their babies, it is also a time when there are unique opportunities for positive intervention. As clinicians, mental health, and community health care providers, it is imperative that we understand the nature of perinatal substance use disorders and provide interventions and care that preserve the parent-infant dyad, promote parenting potential, and support the baby’s health and development.
Research indicates that intimate partner violence is a significant source of ill-health and injury for women. Women who are abused by an intimate partner or family member are more likely to experience unintended pregnancy, delay entry into prenatal care, and experience poor pregnancy outcomes. They are more likely to manifest perinatal mood and anxiety disorders (PMADs) and post-traumatic stress, have higher rates of STDs including HIV, and are at greater risk for problematic substance use. Additionally, the co-occurrence of intimate partner violence and child abuse is estimated to range from 30-60%, adding further danger to the postnatal period.Of great concern is that intimate partner violence during pregnancy is quite common. In fact, research suggests that intimate partner violence impacts pregnancy more often than any other physiological complication of pregnancy.
The National Perinatal Association advocates the position that greater public awareness and professional transparency should assist prospective parents in making informed decisions regarding their potential choices in seeking ART as well as their options involving adoption of the many infants already born who are in need of loving parents.
Studies are urgently needed regarding every aspect of ART, including neurodevelopment outcomes, school performance, and differences in the incidence and onset of adult diseases when conceived using ART versus naturally. As with other technologies that may impact the human genome through epigenetic modification, continued research into the influences of emerging technologies on the health and well being of the infants born should be a national priority.
Postpartum depression is more common in both new fathers and mothers than in the general public, but is often unidentified in fathers. NPA recommends increased awareness of this issue, scheduled screening and appropriate follow up of fathers, as well as mothers, in the first year postpartum year.
As an organization built to align multidisciplinary decision-making, collaborative problem-solving and innovative teaching, NPA recognizes the need for interdisciplinary discussion, reflective planning, and disclosure of transparent and viable options when pursing ongoing healthcare reform. NPA promotes the rights of vulnerable pregnant women, children and families to receive quality healthcare services regardless of socioeconomic status.
The NPA wishes to confirm the value of palliative care and hospice for affected parents and their children, from prenatal diagnosis through childhood. Bereavement support for the family is an essential component of any loss. The NPA wishes to ensure that all children and their families receive culturally competent care at the end of life.
NPA supports comprehensive drug treatment programs for pregnant women that are family- centered and work to keep mothers and children together whenever possible. The most successful treatment models will include access to quality prenatal and primary medical care, child development services, crisis intervention, drug counseling, family planning, family support services, life skills training, mental health services, parent training, pharmacological services, relapse strategies, self-help groups, stress management, and vocational training.
The National Perinatal Association (NPA) opposes legislation defining fetal personhood at conception. The time when a fetus becomes a person should be left for medical experts and patients. The NPA encourages its members to oppose any legislation defining fetal personhood at conception and encourages its members to support legislators in favor of leaving this discussion to the medical sphere.