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Conference promoting a multi-disciplinary approach in caring for pregnant substance misusers
Thursday, March 30, 2006

Agenzija sedqa, the Midwifery Management and the Movement for the Unborn Child, today organised a conference “Caring for Substance Misusing Women in Pregnancy and their Children: Past, Present and Future Perspectives” at the Waterfront Hotel, Gzira.

The aim of the Conference was to promote, through a multi-disciplinary approach, the provision of the highest standards of medical and social services to female substance misusers during pregnancy and their babies, the wholesome development of unborn children, and all that is necessary to help these mothers seek help out of their own free will and also to become good mothers. This conference was held with the assistance of professionals in the field, specifically to increase awareness of the need to protect children from injury and harm caused by substance misuse by parents, especially the mother. The conference aimed to get all professionals working in this field together for the first time to give their past, present and future perspectives in order to increase and improve inter-agency collaboration.

Hon. Dr. Michael Axiak, Member of Parliament on the side of the government, addressed the conference as representative of Minister Dolores Cristina, Minister for the Family and Social Solidarity. He said that in order to ensure safety to both mother and baby, the multi-disciplinary and multi-agency team approach needs to be well co-ordinated and integrated. Good communication between professionals is central to the provision of good quality. All professionals have an equally important role to play in ensuring that a high quality standard of care is delivered to the pregnant woman and her child. It is in the Government’s policy to ensure that clients are provided with a continuum of services that link into each other with ease so as to ensure that the client moves smoothly from one intervention to another. Hon. Axiak acknowledged and commended the excellent work that all professionals are doing with these women and their children.

Dr. Anna Maria Vella and Mr. Jean-Claude Cardona during the conference

National Policies are critical to ensure the protection of children as well as the accountability of service providers. In this respect the sector needs written policies that bind the various operators with regards to their obligations in the provision of services, the response time and the level of service expected, said Mr Jean Claude Cardona, the Operations Director of Agenzija sedqa in his opening address during the conference. The Department of Social Welfare Standards already provides for the assessment of social services. This is a good example to follow on for other areas.

He added that the protection of children has to be viewed holistically as such activity involves a wide cross section of professionals, organisations and services. Therefore effective intervention entails the collaboration of many stakeholders. The current practice that collaboration is dependent on the good will of interested parties, is not good enough. Legislation and National Policies that will hold people and organisations accountable is the way forward. This will guarantee transparency for reasons of public accountability in sensitive areas such as the protection of children.

Mr. Cardona said that female drug addicts, in particular pregnant substance misusers, are often looked down upon and negatively judged by many. Sometimes this leads some people, even providers of services, to perceive these individuals as citizens of a lesser degree and therefore do not necessarily qualify for a given service. It is claimed by a number of professionals working with this group that certain service providers would feel uncomfortable providing a service to pregnant drug misusers. This is not acceptable and in fact the opposite attitude should prevail. Pregnant drug misusers are at great risk for their health and the health of their unborn child and therefore they should have the full attention to manage the pregnancy period as best as possible; thus, securing the health and sometimes even the lives of both.

Mr. Cardona said that the teamwork of various players is critical to ensure effective interventions that provide the best care for the child and the mother. In this respect he called for an approach of support rather then a punitive one that may drive pregnant substance misusers underground, with all the implications that this brings with it. This has always been the approach of the medical team at sedqa and shall continue to prevail as this has been a life saver for many children and their mothers. He also praised the work done by Agenzija APPOGG as it is often the case that social workers from this agency intervene in order to protect children that may be at risk. The collaboration between Agenzija sedqa and Agenzija APPOGG, in particular the Care Services and the Child Protection Service respectively, is exemplary.

Dr. Anna Maria Vella during her presentation

For the past years sedqa has given special care and attention to substance misusing women, said Dr. Anna Maria Vella, registrar at the Substance Misuse Out-Patients Unit of Agenzija sedqa. Their needs are definitely different than those of their male counterparts. An important moment in their life is when they become pregnant. It could be a turning point for the better or it could be the beginning of a difficult life for a child. She added that sedqa believes in a multi-agency approach towards the newly created family. Dr. Vella stressed the importance that all entities should work together to help the mother become the best mother for her child and if the father wants to be involved, he should also be helped to do so. Unfortunately, substance misusing mothers still approach society with defiance and fear at the same time.
The number of women who misuse illicit substances during pregnancy is on the increase. Statistics show that in Malta, babies born to these mothers are nursed in hospital for weeks if not months, denoted Ms. Mary Buttigieg Said, Practice Development Midwife from the Midwifery Movement. When comparing the management of care provided in Malta with that of other European countries, one can note a significant difference. Ms. Buttigieg said that it is evident that professionals from different areas involved are dedicated and perform their very best but unfortunately great effort, resources and benefits are being wasted as the service delivered to these families is fragmented. Hence, parents and their babies can greatly benefit from multi-disciplinary care in a multi-agency approach.

The Malta Movement for the Rights, Protection and Development of the Unborn Child was also represented in the conference by Ms. Nathalie Zammit. Ms. Zammit reaffirmed that no single profession is equipped to cater for the holistic needs of these families. The multi-disciplinary and multi-agency approach can provide client-friendly care and support as it unites the effects, resources and benefits to pregnant substance misusers and their children.

Present at the conference were professionals from various fields who in some way or another come into contact with this clientele in their professional capacity as well as interested members from the public.

Sedqa, the National Agency Against Drug and Alcohol Abuse, offers it Prevention and Care Services both within the community and in residential settings. People requiring help regarding problems related to alcohol abuse can be referred, refer themselves to these services or access more information by calling Helpline 151, or by visiting the Agency’s website www.sedqa.gov.mt.

UPDATE: These are soft copies of the presentations made during the conference.

Midwifery Perspective by Ms. Mary Buttigieg Said [PDF 643 Kb]

Pediatrician's Perspective by Dr. Joseph Mizzi [PDF 2,354 Kb]

Psychological Perspective by Dott. Roberta Attard [PDF 219 Kb]

Social Worker's Perspective by Ms. Daniella Zerafa [PDF 370 Kb]

Education's Perspective by Ms. Carmen Sammut [PDF 49 Kb]

Legal Perspective by Dr. Elaine Ellul [PDF 62 Kb]

Substance Misusing Women's Perspective by Dr. Anna Maria Vella [PDF 53 Kb]

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