In 2011, I asked the question “How do we care for pregnant and parenting people who use drugs?” The question arose from an advisory board convened by my community partner. The advisory board, which consisted of healthcare and social service frontline professionals, realized that no one organization understood or facilitated the care of PPPWUDs. I began a grounded theory study that year to start answering the questions of what was being done, by whom, and how.
Eleven years later, I am still grappling with questions about care but I am focused on how we can reduce the stigma that serves as a barrier to care and how we can increase integrated and coordinated systems of compassionate care. I have published three articles from my grounded theory study that provide a rationale for the need to address these questions. I co-authored two other papers that examined the issues specifically with NICU nurses. I have also been involved with efforts to provide integrated compassionate care and am currently working with a community partner to develop and evaluate effective stigma reduction strategies.
When I started this work, it didn’t have a home. That is, the questions and the problems fall between the cracks of different disciplines and specialties. The care that is needed cuts across agencies, organizations, and systems. It involves reproductive healthcare, addiction treatment, child welfare, and child development services along with the legal system. It has been difficult to find a home for journal articles and funding support. The topic is getting more attention lately but our academic and medical disciplines have become more niched and more siloed over time. This, like many wicked problems, needs a holistic and systems thinking approach.
Tracy R. Nichols, PhD 