Mothering and Opioids: Addressing Stigma – Acting Collaboratively, recently released by the Centre of Excellence for Women’s Health, is a toolkit that provides:

·       Practical ways to respond to others who use stigmatizing language and behaviour when speaking to and about women who use substances in and after pregnancy;

·       Policy and practices that could be adjusted and how to incorporate these changes into practice;

·       How to facilitate cross-system collaboration; and

·       Tips on using this lens when developing new policies, programs and practices.

Created by Rose Schmidt, Lindsay Wolfson, Julie Stinson, Nancy Poole and Lorraine Greaves for the Centre of Excellence for Women’s Health, the toolkit is designed for substance use and child welfare practitioners, as well as other service providers and health system planners who offer services to, or design services with, pregnant women and new mothers who use substances.

The Centre of Excellence for Women’s Health (CEWH) is a research and knowledge exchange centre focused on linking research on gender and women’s health to policy and practice. Since the 1990s, researchers at CEWH have conducted research on topics such as the barriers pregnant women and new mothers face when accessing substance use treatment and support. Since the 2000s, CEWH has invited researchers, service providers, women with lived experience and policy analysts to think critically together as members of virtual communities about how we can improve practice and policy.

The starting point for the project which resulted in the production of the toolkit was the research question “How do women who use opioids (and other substances) experience stigma, pregnancy, parenting and child welfare concerns, and how can this inform harm reduction responses?”

The team then took a synthesis of the findings to their wise women collaborators, Dorothy Badry, Kelly Harding and Sheena Taha . Through their feedback and generosity in sharing their own work, the information was developed into useful, practical and forward-looking tools, which it is hoped will support practice improvement and policy development.

The toolkit is organized into four sections:

·       Addressing Stigma in Practice: examines how women who use opioids experience stigma and includes tools for assessing potentially stigmatizing practices. This section also includes a script for responding constructively to coworkers’ stigmatizing behaviour, as well as a factsheet developed for practitioners by women with lived experience.

·       Improving Programming and Services: describes how stigma relates to the barriers that women face. It identifies promising practice and policy responses that address stigma and health, substance use, and child protection concerns. Tools are provided to facilitate integrating promising approaches into our responses, and to identify ways in which barriers can be overcome

·       Cross-system Collaboration and Joint Action: includes information and tools to facilitate cross-system collaboration. Featured in this section are tools that help identify how the substance use and child welfare fields can effectively collaborate, while responding to their respective mandates and roles in supporting women and children. In this way, care is wrapped around families.

·       Policy Values: discusses policy matters, and how defining and affirming policy values can clarify our work in both systems of care. This section emphasizes viewing mothers and children as a unit when developing policy and programming to facilitate the goal of keeping mothers and children together.

The toolkit highlights promising ongoing work such as the Provincial Perinatal Substance Use project at BC Women’s Hospital + Health Centre, which is involving women with lived experience, service providers, health system planners and researchers in co-creating a blueprint for a continuum of respectful, trauma informed and culturally safe harm reduction and recovery-oriented services for pregnant women and new mothers who use substances, and the research work being done in projects such as the Co-Creating Evidence project (see www.fasd-evaluation.ca ) to identify both substance use and child welfare issues facing women.

Noting, however, that there remains much to be done, especially to involve women with lived experience in defining what works for them, the toolkit promotes practice and policy changes to better respond to the needs of pregnant women and new mothers who use opioids.

The Centre of Excellence for Women’s Health (CEWH) is a research and knowledge exchange centre focused on linking research on gender and women’s health to policy and practice. Since the 1990s, researchers at CEWH have conducted research on topics such as the barriers pregnant women and new mothers face when accessing substance use treatment and support. Since the 2000s, CEWH has invited researchers, service providers, women with lived experience and policy analysts to think critically together as members of virtual communities about how we can improve practice and policy.

The starting point for the project which resulted in the production of the toolkit was the research question “How do women who use opioids (and other substances) experience stigma, pregnancy, parenting and child welfare concerns, and how can this inform harm reduction responses?”

The team then took a synthesis of the findings to their wise women collaborators, Dorothy Badry, Kelly Harding and Sheena Taha . Through their feedback and generosity in sharing their own work, the information was developed into useful, practical and forward-looking tools, which it is hoped will support practice improvement and policy development.