Psychoactive Substance Use Among Pregnant Women

1.1 Introduction

A psychoactive substance is defined as any chemical substance that alters the normal function of the brain and affects mood, perception, consciousness, or behavior (World Health Organization [WHO], 2020). Psychoactive substance use during pregnancy poses significant risks to both maternal and fetal health, leading to a range of adverse outcomes including low birth weight, preterm birth, and developmental issues in children (Raistrick et al., 2020). The prevalence of substance use among pregnant women has been a growing concern globally, with studies indicating that many women may continue to use substances despite being aware of the potential risks to their unborn child (Sinha & Jaiswal, 2019).

In Nigeria, the issue is particularly critical, as traditional practices and socio-cultural factors often influence women's choices regarding substance use during pregnancy (Ameh et al., 2021). Furthermore, limited access to prenatal care and educational resources exacerbates the situation, leaving many women uninformed about the dangers of psychoactive substances (Adediran et al., 2020).

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.

1.2 Background of Study

Historically, substances such as alcohol and tobacco have been socially accepted and widely used by pregnant women, often with little awareness of the potential risks involved. The link between alcohol consumption during pregnancy and adverse outcomes, such as fetal alcohol spectrum disorders (FASDs), became prominent in the late 20th century. In 1973, the term "fetal alcohol syndrome" was first used to describe the pattern of birth defects resulting from alcohol exposure during pregnancy, leading to increased awareness and research on the topic (Jones & Smith, 1973). As understanding of the risks associated with psychoactive substance use expanded, public health campaigns began emphasizing the importance of abstaining from alcohol and other substances during pregnancy. The 1980s and 1990s saw a growing body of research focusing on the consequences of tobacco and illicit drug use during pregnancy, highlighting the potential for complications such as low birth weight, preterm birth, and developmental delays (Martin et al., 2017). In Nigeria, the historical context of psychoactive substance use among pregnant women is influenced by cultural practices and social norms that often shape attitudes toward substance consumption. Traditional practices surrounding pregnancy have sometimes included the use of herbal remedies and psychoactive substances, complicating efforts to educate women about the potential risks associated with these substances (Odebiyi et al., 2021). As public awareness of the dangers of substance use during pregnancy has grown, so too has the call for comprehensive health education and support services for pregnant women, particularly in regions where cultural norms may support such practices.

The background of psychoactive substance use among pregnant women highlights a critical public health issue that has gained significant attention in recent years. Psychoactive substances, including alcohol, tobacco, illicit drugs, and prescription medications, can adversely affect maternal health and fetal development (Gundersen et al., 2019). Research indicates that substance use during pregnancy can lead to a range of complications such as fetal alcohol spectrum disorders (FASDs), neonatal withdrawal syndrome, and developmental delays in children (Chisolm et al., 2021).

In many societies, cultural beliefs and social norms play a crucial role in shaping women's attitudes towards substance use during pregnancy. In Nigeria, traditional practices may either stigmatize or normalize substance use, making it challenging for pregnant women to seek help or avoid these substances (Odebiyi et al., 2021). Additionally, many women lack adequate knowledge about the risks associated with psychoactive substance use, often resulting from insufficient education and healthcare access (Fawole et al., 2020). The World Health Organization (WHO) emphasizes the importance of addressing substance use in pregnant women, recognizing it as a significant factor influencing maternal and child health outcomes (World Health Organization, 2020). Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the psychoactive substance use among pregnant women.

1.3 Statement of Problems

Investigation revealed that the issue of psychoactive substance use among pregnant women is a significant public health concern that poses serious risks to both maternal and fetal health. Research indicates that the prevalence of substance use during pregnancy is alarmingly high, with studies showing that many women engage in the use of alcohol, tobacco, and illicit drugs, often without understanding the potential consequences (Chisolm et al., 2021). In many regions, cultural norms and societal pressures contribute to the normalization of substance use, making it challenging for pregnant women to seek help or refrain from these substances (Odebiyi et al., 2021). Moreover, stigma surrounding substance use issues often results in pregnant women feeling isolated and reluctant to disclose their substance use, thereby hindering appropriate intervention and support (Gundersen et al., 2019). It is against the backdrop that this study seeks to address these problems by evaluating the psychoactive substance use among pregnant women.

1.4 Aim and Objectives of Study

The aim of the study is to investigate the psychoactive substance use among pregnant women. In achieving this aim, the following specific objectives were laid out as follows:

1. To assess the knowledge and attitudes of pregnant women towards the risks of psychoactive substance use on maternal and fetal health.
2. To evaluate the impact of psychoactive substance use on pregnancy outcomes, including maternal health and fetal development.
3. To explore the barriers faced by pregnant women in accessing support and resources to reduce substance use.
4. To determine the prevalence of psychoactive substance use among pregnant women in the study area.
5. To identify the types of psychoactive substances commonly used by pregnant women.
6. To examine the demographic and socio-economic factors associated with psychoactive substance use during pregnancy.
7. To recommend strategies for health education and intervention programs aimed at reducing psychoactive substance use among pregnant women.

1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• What is the prevalence of psychoactive substance use among pregnant women in the study area?
• What types of psychoactive substances are commonly used by pregnant women?
• What demographic and socio-economic factors are associated with psychoactive substance use during pregnancy?
• What is the level of knowledge and awareness among pregnant women regarding the risks of psychoactive substance use on maternal and fetal health?
• What attitudes do pregnant women hold towards substance use and its consequences during pregnancy?
• What barriers do pregnant women encounter when seeking support and resources for substance use reduction?
• What are the observed impacts of psychoactive substance use on pregnancy outcomes, including maternal health and fetal development?
• How effective are existing health education and intervention programs in addressing psychoactive substance use among pregnant women?

1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

• H₀1: There is no significant relationship between psychoactive substance use and adverse pregnancy outcomes among pregnant women.
• H₀2: There is a significant prevalence of psychoactive substance use among pregnant women in the study area.
• H₀3: Pregnant women with lower socio-economic status are more likely to engage in psychoactive substance use compared to those with higher socio-economic status.
• H₀4: Pregnant women who experience higher levels of stress are more likely to use psychoactive substances compared to those with lower stress levels.

1.7 Significance of Study

The outcome realized from the research findings will have significance for various stakeholders:

1. Healthcare providers will benefit from a better understanding of the prevalence and types of psychoactive substances used by pregnant women, enabling them to tailor their counseling and treatment approaches effectively.
2. Policymakers will gain crucial data that will inform the development of targeted public health initiatives and policies aimed at reducing substance use during pregnancy and improving maternal and child health outcomes.
3. Pregnant women will receive increased awareness regarding the risks associated with psychoactive substance use, empowering them to make informed decisions about their health and the health of their unborn children.
4. Community organizations and support groups will find the findings useful for creating programs and resources that address the needs of pregnant women struggling with substance use, thereby fostering a supportive environment.
5. Researchers and academicians will benefit from the study's contributions to the existing literature on substance use and maternal health, opening avenues for further research and exploration in this critical area.

1.8 Scope of the Study

The scope of the research is focused on psychoactive substance use among pregnant women attending Warri Central Hospitcal, Sapele, Delta State.

1.9 Limitations of the Study

The study on psychoactive substance use among pregnant women faced several limitations that may have affected the results and generalizability of the findings.

1. There was delay from respondents in providing the necessary information, which extended the data collection period and could have impacted the study's timeline. Such delays may have resulted in a smaller sample size than originally intended.
2. Furthermore, financial and time constraints were significant factors that limited the scope of the study. The budget allocated for the research was insufficient to cover all planned activities, such as extensive outreach programs or follow-up interviews, which could have enriched the study's findings.

1.10 Definition of Terms

Psychoactive Substance: A psychoactive substance is defined as any chemical substance that alters the normal function of the brain and affects mood, perception, consciousness, or behavior (World Health Organization [WHO], 2020). This category includes a range of substances, including alcohol, illicit drugs, and prescription medications, which may have varying impacts on individuals, especially pregnant women.

Substance Use: Substance use refers to the consumption of psychoactive substances, which may occur in various forms such as occasional use, regular use, or dependence (American Psychiatric Association [APA], 2013). During pregnancy, substance use poses unique risks to both maternal health and fetal development, leading to adverse outcomes.

Pregnant Women: Pregnant women are defined as females who are in the gestational period, which is characterized by the development of a fetus within the uterus. This period typically lasts around nine months and is divided into three trimesters (American College of Obstetricians and Gynecologists [ACOG], 2018). The health behaviors of pregnant women, including substance use, significantly influence both their own health and that of their unborn children.

Maternal Health: Maternal health encompasses the health of women during pregnancy, childbirth, and the postpartum period. It is a critical aspect of overall public health, as it directly affects fetal health and development (WHO, 2019). Issues related to maternal health include access to prenatal care, nutrition, and substance use, all of which can significantly impact pregnancy outcomes.

Fetal Development: Fetal development refers to the process by which the fetus grows and matures in the womb during pregnancy. This process is influenced by various factors, including maternal health behaviors such as substance use, nutrition, and environmental exposures (Moore & Persaud, 2018). Proper fetal development is essential for the health and well-being of the child after birth.