Table 3 Key characteristics
Author (Year) | Document Title | Country | Context—Region/Setting | User (e.g., midwives) | Aim / purpose of document | How does document relate to women using drugs in perinatal period? | Stage it applies on the perinatal journey | Refers to PWWUD as being vulnerable/disadvantaged? |
|---|---|---|---|---|---|---|---|---|
Greater Glasgow and Clyde NHS (2016) | [CG] Use of alcohol and other drugs in pregnancy: guideline for management flowchart [26] | Scotland | Regional/Greater Glasgow & Clyde/Hospital | Medical (Obs & Gynae, midwives, nurses) | Outlines the medical management of pregnant women who use alcohol and others drugs during pregnancy | Whole document is dedicated to medical management of pregnant women who use alcohol, illicit and prescribed benzodiazepines and opiates | Pregnancy | No |
Greater Glasgow and Clyde NHS (2016) | [CG] Use of benzodiazepines in pregnancy. Guidelines for obstetric management [27] | Scotland | Regional/Greater Glasgow & Clyde/Hospital | Medical (Obs & Gynae, midwives, nurses) | Provides guidelines for management and detox from benzodiazepines for pregnant women | Whole document is dedicated to the medical management of detox for women who are pregnant from Benzodiazepines | Pregnancy | No |
Greater Glasgow and Clyde NHS (2016) | [CG] Use of Opiates in pregnancy. Guidelines for obstetric management [28] | Scotland | Regional/Greater Glasgow & Clyde/Hospital | Medical (Doctor's prescribing guidance) | Outlines the medical management of women who use opiates while pregnant | Whole document is dedicated to the medical management of pregnant women who use opiates while pregnant | Pregnancy | No |
BASW—Hulmes, A. and Galvani, S. (2019) | A child's first 1000 days: the impact of alcohol and other drugs [29] | UK—wide | UK wide / Any setting | Social Workers | Provides guidance for social workers working with parents who use drugs / alcohol within the first 1000 days of a baby’s life (conception up until aged 2 yrs.) | Whole document is relevant and specific to women who use drugs during the perinatal period | Perinatal period | No |
Blackpool Better Start. Centre for Early Child Development (2021) | A good practice guide to support the implementation of trauma informed care in the perinatal period [30] | England | Regional/Blackpool/Community & Hospital | All healthcare staff working with perinatal women | Aims to offer additional support for all staff (clinical and non-clinical) working with women in the perinatal period to strengthen trauma informed care practices | Whole document refers to women experiencing trauma during the perinatal period and acknowledges that substance using women may experience trauma | Perinatal period | Yes |
Department of Health, Social Services and Public Safety NI (2012) | A Strategy for Maternity Care in Northern Ireland 2012–2018 [31] | Northern Ireland | National / Maternity services—Community & Hospital | Maternity care providers—Nursing, Midwifery & Allied health services | Document outlines strategic direction and clear objectives for maternity care provision in Northern Ireland. 6 | Document is applicable as universal for all pregnant women but also lists pregnant women who use drugs as a category at higher risk of health inequalities, and of high-risk pregnancies. There are fleeting specific references to their care throughout, and to the NICE guidelines CCG 110 | Perinatal period | Yes |
University Hospitals Birmingham NHS Foundation Trust (2019) | Abstinence Syndrome [32] | England | Regional/Birmingham/Hospital | Medical (Neonatal medical, midwifery and nursing staff and staff on postnatal wards) | To outline information regarding the management of infants at risk of neonatal abstinence syndrome | The whole document is relevant as it refers to the care of infants who have developed NAS, and by association covers PWWUD | Postnatal period | No |
NHS Orkney & Orkney Island Council (2020) | Additional support pathway for women with vulnerabilities [33] | Scotland | Regional / Orkney / Community & Hospital | Midwives | Guidance for midwives around identifying, assessing, supporting, and managing unborn babies where there are identified risk factors / concerns | The whole document is relevant as drug use is listed as a complex medical factor which can impact vulnerability for mother and baby | Pregnancy | Yes |
NICE (2014; 2020) | Antenatal and postnatal mental health: clinical management and service guidance [34] | UK—wide | National / Hospital | Healthcare professionals, Commissioners, Social services, Voluntary and private sectors | This guideline covers recognising, assessing, and treating mental health problems in women who are planning to have a baby, are pregnant, or have had a baby or been pregnant in the past year | The document contains a relevant section on alcohol and drug misuse in pregnancy (pg.36) | Perinatal period | No |
NICE (2021) | Antenatal Care [35] | UK—wide | National / Any setting | Healthcare Professionals, Commissioners, and providers of maternity care | This guideline covers the routine antenatal care that women and their babies should receive. It aims to ensure that pregnant women are offered regular check-ups, information, and support | It is applicable as a universal document for all pregnant women. In relation to the specific care needs of pregnant women using drugs it refers to the NICE guidance on Pregnancy and complex social factors | Pregnancy | Yes |
Royal College of Obstetricians and Gynaecologists (2012) | Bacterial Sepsis Following Pregnancy. Green–top Guideline No. 64b, [36] | UK—wide | National / Hospital | Medical (Doctors, clinicians and healthcare professionals working with pregnant women) | To provide guidance for obstetricians, gynaecologists, and related medical professionals on the management of sepsis in the puerperium | Document contains a relevant section related to PWWUD and links to bacterial sepsis (pg6) | Postnatal period | No |
Lingford-Hughes, Welch, Peters and Nutt (2012) | BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP [37] | UK—wide | National / Any setting | Pharmacists | This guideline relates to the pharmacological management of withdrawal, short- and long-term substitution, maintenance of abstinence and prevention of complications, where appropriate, for substance abuse or harmful use or addiction as well management in pregnancy, comorbidity with psychiatric disorders and in younger and older people | There is a specific section on the pharmacological management of pregnant women and recommended practice for the assessment/antenatal care, opioids, methadone, buprenorphine, slow-release oral morphine, detoxification, and stimulants | Pregnancy | No |
Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group (2021) | Benzodiazepines and Z-drugs as Hypnotics and Anxiolytics [38] | England | Regional/Bristol / Any setting | Medical (clinicians and local practitioners) | A support document consolidating national guidance, expert opinion, and local resources to aid local practice including prescribing, de-prescribing/withdrawal and self-care | Contains a relevant section to PWWUD on prescribing benzodiazepines | Perinatal period | No |
Public Health England (2017) | Better care for people with co-occurring mental health and alcohol/drug use conditions [39] | England | National / Any setting | Commissioners and service providers of mental health and drug treatment services | Guidance for service providers and commissioners to inform provision of services for people with co-occurring mental health and alcohol / drug use conditions | PWWUD or have recently given birth and have a co-occurring mental health condition are recognised as a vulnerable group, and the document contains specific as well as generic practice recommendations for them | Perinatal period | Yes |
Care Quality Commission (2018, reviewed 2019) | Brief guide: Substance misuse services – People in vulnerable circumstances [40] | England | National/Community | All health and social care providers, practitioners, and service inspectors | Outlines that people using substance misuse services may need extra support temporarily or long-term either because of their personal circumstances, the health conditions they have, or other needs and complexities | Whole document is relevant, and includes specific sections—PWWUD listed as a specific population who may be vulnerable to risk, includes specific mention of risk to mother and child on p.5 | Perinatal period | Yes |
British Association for Psychopharmacology (2017) | British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017 [41] | UK—wide | National / Specific Professions /Any setting | Healthcare professionals (e.g., neurologists, psychiatrists) | Guidance around the use of psychotropic medication in pregnancy and post-partum | Specific suggestions are made in relation to prescribing medications for PWWUD | Pregnancy | No |
Change, Grow, Live (2019) | Change, Grow, Live (CGL) Procedure: Substance Misuse in Pregnancy [42] | UK—wide | Organisational/Hospital & Community | Healthcare professionals who work with PWWUD (CGL permanent and temporary staff, volunteers and sub-contracted agencies involved in delivering or supporting services offered by the organisation) | This procedure has been produced to provide information to health care professionals involved in the care of pregnant women who have drug problems, to enable them to provide appropriate care and advice | Whole document is relevant and outlines care of PWWUD | Perinatal period | Yes |
Aberdeen Alcohol & Drugs Partnership (2019) | Charter 3.2 Births affected by drugs (Health improvement plan) [43] | Scotland | Regional / Aberdeen/ Any setting | Community Planning Aberdeen Partnership members & Aberdeen Drug & Alcohol Partnership members (Local statutory & non-statutory service providers) | To reduce the number of births in Aberdeen affected by drugs by 0.6%, by 2022 | Whole document is relevant to PWWUD | Pregnancy | Yes |
NICE (2017) | Child abuse and neglect [44] | UK—wide | National/Hospital & Community | All practitioners who encounter children & young people, including commissioners, managers and risk assessment practitioners | Aims to help anyone whose work brings them into contact with children and young people to spot signs of abuse and neglect and to know how to respond | Document contains some mentions of PWWUD in relation to child abuse and neglect | Perinatal period | No |
Outer Hebrides Drug and Alcohol Partnership and Outer Hebrides Child Protection Committee (2018) | Children affected by parental drug or alcohol related problems GIRFEC oriented inter-agency guidelines [45] | Scotland | Regional / Outer Hebrides / Any setting | Any agency or professional working with children | To provide clarity about what is expected of staff working with children, and who does what within an interagency context. They must be used together within the context of Outer Hebrides Inter-agency Child Protection Procedures (2015). For staff working with adults these are supplementary to the Single Shared Assessment | Whole document is relevant to PWWUD as pregnancy is identified as a critical period, and they are considered with the context of children living with parents who use substances problematically. There is also a specific section dedicated to the "Management of pregnant substance users" | Perinatal period | Unclear |
HIPS Safeguarding Children Partnership (2022) | Children living in households where there is substance misuse [46] | England | Regional / Hampshire, Isle of Wight, Portsmouth and Southampton / Any setting | All staff and agencies working with children, and families; all local authorities, clinical commissioning groups, police and all other organisations and agencies | Specific local safeguarding protocol for children where parents misuse substances | There is a specific section about substance misuse in pregnancy | Perinatal period | Unclear |
Hull Safeguarding Children Partnership (2022) | Children of parents or carers who misuse substances [47] | England | Regional / Hull / Any setting | Community Services / Members associated with Hull Safeguarding Children's Partnership | Guidance for Hull Safeguarding Partnership which outlines procedure dealing with children of substance using parents | Document contains a specific section on substance misuse under 'Risks' | Perinatal period | Yes |
Regional Child Protection Procedures for West Midlands (2022) | Children of parents who misuse substances [48] | England | Regional / West Midlands / Any setting | Any agency or professional working with women who use drugs, parents and or children | Specific local child protection procedures where parents use substances | There are specific references throughout to pregnant women who use substances | Perinatal period | Yes |
South Lanarkshire Partnership (2021) | Children's Service Plan: 2021–2023 [49] | Scotland | Regional / South Lanarkshire / Hospital & Community | Partnership members—Medical/Local NHS/Community/Police + Fire etc | Regional plan for children’s services in South Lanarkshire | The document contains relevant mentions children and young people affected by substance use in pregnancy remaining an area of need (p.26) | Perinatal period | Unclear |
HM Prison Service (2000) | Clinical services for substance users [50] | UK—wide | National / Specific Profession / Prison | Staff working in prison | Outlines evidence-based standards for effective clinical management of people for "substance misusers" | This document applies to PWWUD and are in prison as universal document but also contains specific recommendations regarding local policy provision within each prison as well as in relation to their treatment and care | Perinatal period | No |
NICE (2016) | Coexisting severe mental illness and substance misuse: community health and social care services [51] | UK—wide | National / Hospital & Community | Community and mental health service commissioners and providers/Primary care providers/Staff in the criminal justice system | The document covers how to improve services for people aged 14 and above who have been diagnosed as having coexisting severe mental illness and substance misuse. It aims to provide a range of coordinated services that address people's wider health and social care needs, as well as other peripheral challenges such as employment and housing | The document contains relevant mentions to the care of the population and their mental health care—identifies PWWUD as a particularly vulnerable group | Pregnancy | Yes |
Derbyshire Safeguarding Children Board (2020) | Derby and Derbyshire Multi Agency Protocol for Pre-Birth Assessments and Interventions [52] | England | Regional/ Derbyshire / Any Setting | Any agency or professional working with pregnant women and their families | Safeguarding protocol around pre-birth assessment where there are concerns identified about the unborn baby’s well-being | Whole document is relevant as PWWUD are identified as they are identified as vulnerable group potentially in need of early help. There is also a specific section for "Parents with Substance (drugs and /or alcohol) Issues", and recommended actions to be taken in their assessment and support | Pregnancy | No |
The Royal College of Psychiatrists and the Faculty of Forensic and Legal Medicine (2020) | Detainees with substance use disorders in police custody: Guidelines for clinical management [53] | UK—wide | National/Specific Profession/Police stations | Healthcare professionals working in the field of forensic and legal medicine | Guidelines developed for staff (including healthcare practitioners) who work with detainees in custody with substance use problems | Document includes a specific Sect. (2.2.4) on pregnant detainees | Pregnancy | Unclear |
Department of Health -Clinical Guidelines on Drug Misuse and Dependence Update 2017 Independent Expert Working Group (2017) | Drug misuse and dependence UK guidelines on clinical management [54] | UK—wide | National / Any setting | Healthcare professionals, Providers and commissioners of treatment for people who misuse or are dependent on drugs | Provides guidance for clinicians prescribing and / or delivering drug treatment for people who misuse or are dependent on drugs | The document applies to PWWUD as they are people who misuse or are dependent on drugs. There is also a specific section on pregnancy and neonatal care | Perinatal period | No |
Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust (2017) | Drug Misuse Management in the Acute Hospital Setting – guidelines [55] | England | Regional/Doncaster and Bassetlaw/Hospital | Medical/Nursing staff | To act as a resource in the management of patients with drug misuse issues, how to deal with common problems that arise and how to signpost / refer to community treatment providers | Document includes a Sect. (11.3) refers to the care of PWWUD | Pregnancy | No |
National Collaborating Centre for Mental Health (2019) | Drug misuse: Opioid detoxification The NICE Guideline [56] | UK—wide | National / Any setting | Clinicians and service commissioners | To provide guidance on the clinical management of opioid detoxification | There are specific references throughout to pregnant women who use substances | Perinatal period | Unclear |
NHS (2021) | Equity and equality Guidance for local maternity systems [57] | UK—wide | National / Hospital & Community | Maternity care service providers and practitioners | This guidance seeks to respond to the findings of MBRRACE-UK report which found worse maternal and perinatal mortality outcomes for those from Black, Asian and Mixed ethnic groups and those living in the most deprived areas | The document covers relevant management of women with complex social factors (p.19), and PWWUD are identified as a category at risk of extreme disadvantage | Pregnancy | Yes |
NHS Lothian (2021) | Expressed breast milk: Information for carers of vulnerable babies [58] | Scotland | Regional / Lothian / Community | Carers of vulnerable babies | Guidance for carers of vulnerable babies regarding breastfeeding | Document is relevant to babies born to PWWUD, whose babies may be cared for by someone else. There is also a specific section on substance misuse and breastfeeding | Perinatal period | No |
Scottish Government (2021) | Families Affected by Drug and Alcohol Use in Scotland: A Framework for Holistic Whole Family Approaches and Family Inclusive Practice [59] | Scotland | National/Community | Commissioners/Service delivery agencies /partnerships which have a collective leadership role in relation to alcohol and drug related harms | Provides a framework, in line with other national drug/alcohol strategies and linked policy initiatives for the development and delivery of a consistent approach for families affected by substance use across Scotland | The document is universal and is relevant as it relates to families affected by drug and alcohol use | Perinatal period | Yes |
North Lanarkshire CPC & South Lanarkshire CPC & Lanarkshire ADP (2015) | Getting it Right for Children and Families Affected by Parental Alcohol and Drug Use in Lanarkshire [60] | Scotland | Regional / Lanarkshire / Any setting | All practitioners working with children and families affected by problematic parental drug / alcohol use | Good practice framework for all practitioners working with children and families affected by parental drug / alcohol use | Whole document is relevant, but there are also specific references to PWWUD, and sections on maternity and neonatal care, and pre-birth child protection case conferences | Perinatal period | Yes |
(ELBEG-PP 2013) Whittaker, A., Templeton, L., Mitchell, F., Hill, L. & Neilson, A. (2013) | Getting it right for children and families affected by parental problem alcohol and drug use: Guidelines for agencies in Edinburgh and the Lothians [61] | Scotland | Regional/The Lothians/Hospital & Community | Medical/Community/Service delivery—agencies who may work with families where this is drug misuse | Provides an operational framework applicable to all statutory and third sector agencies and practitioners to ensure that they work together to promote the welfare of, and to safeguard children. It outlines guidelines for staff and agencies in relation to screening, assessment, information sharing, support and intervention for all children and parents, including expectant parents | The document contains a relevant section related to the multiagency guidance and procedure for children and unborn babies of pregnant women who use drugs (Sect. 9) | Perinatal period | Yes |
Scottish Government (2013) | Getting Our Priorities Right (GOPR) [62] | Scotland | National / Any setting | All practitioners working with children and families affected by problematic parental drug / alcohol use | To provide an updated good practice framework for all child and adult service practitioners working with children and families affected by problem parental alcohol and/or drug use | The whole document is relevant to PWWUD, mothers who use drugs and their babies, however there are also a few specific references to best practice procedures for this population | Perinatal period | Yes |
Forth Valley Drug Partnership and Child Protection Committee (2019) | Getting Our Priorities Right for Children and Families affected by Parental Alcohol and Drug Use: Guidance from the Forth Valley Alcohol and Drug Partnerships and Child Protection Committees [63] | Scotland | Regional/Forth Valley/Hospital & Community | Medical/Community/Service delivery—agencies who may work with families where this is drug misuse | Developed to support practitioners and managers in their work with adults, children, young people and families affected by problematic parental drug and/or alcohol use. It is aimed at those working in children and adult services within the public, private and third sector agencies across Forth Valley | The document contains a specific section—4a) Pregnancy and the unborn child (pg. 33) which contains "Key messages from National Guidance" | Perinatal period | Unclear |
East Ayrshire Child Protection Meeting (2014) | Good Practice—Working with Pregnant Women with Parental Substance Misuse [64] | Scotland | Regional/ East Ayrshire/ Any setting | Child Protection committee members and practitioners working with women who are referred on vulnerable pregnancy care pathway | "To provide East Ayrshire Child Protection Committee (EACPC) and other relevant individuals with a rationale relating to the effectiveness of interventions in improving outcomes for problematic substance use. To support practitioners in evidence-based practice to inform work with women referred under the High-Risk Pregnancy protocol due to substance misuse in pregnancy." | The whole document is specific to PWWUD | Perinatal period | Unclear |
Department of Health, Social Services, and Public Safety (2020) | Guidance for Alcohol and Drug services in Northern Ireland to best deliver treatment and care during the COVID-19 pandemic [65] | Northern Ireland | National/Hospital & Community | Practitioners working in alcohol and drug services | Developed during the beginning of the Covid-19 outbreak/lockdowns, the guidance, aimed at Alcohol and Drugs services in Northern Ireland, outlines the how care and services will continue and adapt during Covid-19 | The document contains mentions of PWWUD and their vulnerability to Covid-19 | Pregnancy | No |
NHS Grampian (2019) | Guidance for the use of buprenorphine products for the treatment of opioid dependence in NHS Grampian [66] | Scotland | Regional / Grampian / Any setting | Practitioners involved in prescribing buprenorphine | Outlines procedure for prescribing buprenorphine products for managing opioid dependence | Document contains specific sections on the use of burenorphine during pregnancy and breastfeeding | Perinatal period | No |
Barnsley Safeguarding Children Partnership (2022) | Guidelines for multi-agency assessment of pregnant women and their babies in cases where there is substance misuse [67] | England | Regional/Barnsley/Hospital & Community | All practitioners working to safeguard children (inc. police, healthcare practitioners, local authority and third sector) | These guidelines encourage early uptake and normalising of antenatal care for substance using women whilst signposting relevant additional services, the establishing of an action plan to meet the needs of the pregnant women and her family (including additional children), and that communication exist between all engaged professionals to ensure concerns are dealt with appropriately | Whole document is relevant, relating to the multi-agency care of pregnant women who use drugs | Perinatal period | No |
Leeds City Council (2010) | Guidelines for the assessment of parental substance misuse [68] | England | Regional / Leeds / Community | Social care workers | Outlines procedures for social care staff working with families where there is parental substance misuse | Whole document applies to PWWUD and mothers who use drugs. There are also specific recommendations made for this population | Perinatal period | Unclear |
St Mungo's (2017) | Homeless Pregnancy Toolkit [69] | UK—wide | National/Community | Staff working with homeless pregnant women | To improve outcomes for homeless pregnant women and improve health and development outcomes for babies born to homeless women by creating equitable quality of service and consistency of approach for all pregnant homeless women. It also aims to implement good practice for homeless women with complex social needs | Whole document is relevant, and includes a specific section on Substance Use (pg.6) | Perinatal period | Yes |
NHS (2017) | Implementing Better Births, a resource pack for local maternity systems [70] | England | National / Any setting | Maternity Services | Guidance for all maternity services to implement vision set out in Better Births document | Whole document is relevant as universal to maternity care services. There is only one specific mention of pregnant women who use drugs | Perinatal period | No |
Glasgow Child Protection Committee (2008) | Inter-Agency procedural guidance for vulnerable women during pregnancy [71] | Scotland | Regional / Glasgow / Any setting | Any agency or professional working with vulnerable pregnant women and their families | Child protection guidance to support vulnerable parents to ensure their child's safety | Whole document is relevant and specific to women who use drugs during the perinatal period, as substance misuse is identified as factor attributed to vulnerability in pregnancy | Perinatal period | Yes |
NICE (2014; 2017) | Intrapartum care for healthy women and babies [72] | UK—wide | National/Hospital | Healthcare Professionals, Commissioners and providers of maternity care | The guidance the care of healthy women and their babies, during labour and immediately after the birth, and helps women to make an informed choice about where to have their baby. The document also aims to reduce variation in areas of care such as foetal monitoring during labour and management of the third stage of labour | The document mentions women who use drugs recreationally, and their care needs | Pregnancy | No |
NICE (2019) | Intrapartum care for women with existing medical conditions or obstetric complications and their babies [9] | UK—wide | National / Any setting | Obstetricians, midwives, anaesthetists and other healthcare professionals caring for women in labour; Providers and commissioners of maternity services; Pregnant women, their families and carers | Clinical guidance on care during labour and birth for women who need extra support because they have a medical condition or complications in their current or previous pregnancy, and women who have had no antenatal care | The whole document is relevant for some PWWUD | Perinatal period | Yes |
Wilson, C., Boxhall, C. and Kelleher, M. (2019) | Lambeth drug and alcohol service guidelines for the management of substance misuse in the perinatal period [73] | England | Regional/Lambeth/Any setting | Maternity and addiction service providers | The guidelines aim to facilitate a coordinated approach to supporting women misusing substances and their families in the perinatal period. It places focus on joint working between maternity and addictions services, alongside other agencies | The whole document is relevant as it refers to the management of addictions during the perinatal period (inc. substances/opioids, alcohol and tobacco) | Perinatal period | Yes |
Royal College of Obstetrics and Gynaecology (2010; 2017) | Late intrauterine foetal death and stillbirth [74] | UK—wide | National / Any setting | Obstetricians and midwives | To identify evidence-based options for women (and their relatives) who have a late intrauterine foetal death (IUFD): after 24 completed weeks of pregnancy) of a singleton foetus, and provide guidance on care before, during and after birth, and care in future pregnancies | The whole document is universally relevant if a PWWUD has an IUFD. There are also specific to references to testing the foetus for indications of substance misuse | Perinatal period | No |
NICE (2021) | Looked-after children and young people [75] | UK—wide | National/ Any setting | All social, health and education practitioners looking after children including commissioners, managers and policymakers | The guidance document outlines how organisations, practitioners and carers should work together to deliver high-quality care, stable placements and nurturing relationships for looked-after children and young people | The document includes references to PWWUD in relation to child and family reunification proceedings | Perinatal period | No |
University Hospitals Birmingham NHS Foundation Trust (2020) | Management of substance misuse in pregnancy [76] | England | Regional/Birmingham/Hospital | All staff working within maternity (Obstetrics, Midwifery, Anaesthetics, Neonatologists) | The document's aim is to reduce maternal and neonatal morbidity and mortality associated with substance misuse in pregnancy. It outlines the implications of substance misuse in pregnancy, both for mother and baby, appropriate referral criteria and care pathways and discharge planning | The whole document is relevant; it covers the care of PWWUD from the antenatal period to discharge and follow-up appointments. It includes management of specific substances, and the care pathways and referrals necessary for midwives managing PWWUD | Perinatal period | Yes |
University Hospitals Plymouth (2019) | Management of substance use during pregnancy and the postnatal period [77] | England | Regional / Plymouth/ Hospital | Healthcare practitioners | Provide guidance for healthcare practitioners in relation to their role and responsibilities to ensure they provide appropriate care and know who to refer on to / seek guidance from | The whole document is specific to PWWUD | Perinatal period | Yes |
Royal College of Obstetricians and Gynaecologists (2011) | Management of women with mental health issues during pregnancy and the postnatal period [78] | UK—wide | National/Specific Profession/Hospital | Obstetricians and midwives | Aims to highlight the role of maternity services in the early identification of high-risk women and assessment of current mental illness and describes principles of service organisation for health providers to meet these needs | The document includes recommendations for discussing drug use in pregnant women, and subsequent care | Perinatal period | Unclear |
NHS York Teaching Hospital (2019) | Maternity services guideline: Antenatal appointments guideline [79] | England | Regional / York / Community | Maternity health care professionals | Provide a framework "to enable the consistent provision of high quality, evidence based holistic care to pregnant women" accessing the Trust maternity services | Is applicable as a universal document for all pregnant women, but also identifies women who misuse drugs during pregnancy in the 'high-risk' category | Perinatal period | No |
Evelina London and NHS Guy's and St Thomas' NHS Foundation Trust (2021) | Maternity substance misuse in pregnancy guideline [80] | England | Regional/ London/ Hospital | Obstetricians and midwives | Provides guidance on the management of substance misuse in pregnancy and the immediate post birth period | The whole document is relevant as it outlines the care of PWWUD and their babies from Antenatal booking appointments to discharge. It refers to in-hospital/in-patient care and hospital-based appointments | Perinatal period | No |
Wolverhampton Safeguarding Children Board (2013) | Multi-Agency Guidance Hidden Harm – Parental substance misuse and the effects on children [81] | England | Regional / Wolverhampton / Any setting | Practitioners working with children or families where parental substance misuse is an issue | Guidelines for multi-agency practitioners in Wolverhampton working with children, young people and families and/or adults who have care of children where substance misuse is a factor which affects their lives. To provide: information on substance misuse and how this may impact upon an individual’s ability to care for a child, a structure for communication and collaborative working, and a risk management tool. "The purpose of this practice guidance is to assist staff in all agencies in identifying situations where action is needed to safeguard a child and promote their welfare as a result of their parent’s drug and / or alcohol use." | The whole document is relevant to PWWUD, mothers who use drugs and their babies, and there is a specific section on "Pregnancy and the Unborn Baby" | Perinatal Period | Yes |
Scottish Government (2021) | National Guidance for Child Protection in Scotland 2021 [82] | Scotland | National/ Any setting | All staff working with children and families | Outlines the expectations and responsibilities for those engaged in protecting children and will support the care and protection of children | The document contains mentions of PWWUD and their children in relation to care proceedings and safeguarding | Perinatal period | Yes |
Highland Council & NHS Highland (2020) | North Highland Vulnerable Pregnancy Pathway—Taking a trauma informed approach in understanding and responding to vulnerability in pregnancy [83] | Scotland | Regional / North Highland / Community | All staff in agencies working with vulnerable pregnant women | "The purpose of this protocol is to ensure standardised timely and proportionate care is received by all vulnerable women and their families across North Highland. It aims to provide clear guidance for staff around roles and responsibilities and expected timescales for those who may need multi agency support. "(2) | This document is relevant as is universal to all pregnancies identified as vulnerable—it has a few specific references to pregnant women who use substances throughout and refers to another guideline for this population | Pregnancy | No |
Staffordshire, Shropshire & Black Country Newborn and Maternity Network and Southern West Midlands Maternity and Newborn Network (2017) | Obstetric Guidelines 2017–19 [84] | England | Regional/The Midlands/ Hospital | All staff in obstetric management | The document functions as guidance for all staff working in obstetric management, and aims to create a more uniform standard of care across the Staffordshire, Shropshire & Black Country and Southern West Midlands Newborn and Maternity Networks’ hospitals | The document contains references to PWWUD in relation to antenatal care, mental health care during pregnancy and in postnatal care | Perinatal period | Yes |
NICE (2022) | Opioid dependence: Scenario: Managing special circumstances [85] | UK—wide | National / Any setting | Clinicians prescribing treatment for opioid dependency | Provides specific guiding on managing opioid dependency in specific circumstances | The document contains a relevant section on opioid management in pregnancy | Perinatal period | No |
Orkney Health and Care (2021) | Orkney Alcohol and Drugs Partnership Strategy 2021–31 [86] | Scotland | Regional/ Orkney/ Any setting | All practitioners working with children and families affected by problematic parental drug / alcohol use | The strategy outlines the vision, outcomes and approach to delivery of the Orkney Alcohol and Drugs Strategy and considers associated local and national policy to reduce drug and alcohol related harm | The document contains mentions of PWWUD and family care | Perinatal period | No |
Outer Hebrides Community Planning Partnership (2020) | Outer Hebrides integrated children's services plan [87] | Scotland | Regional/Outer Hebrides / Any setting | All practitioners working with children, young people and families | The Integrated Services Plan outlines the joint vision, shared priorities and the common outcomes the partnership aims to achieve for children, young people and families in the Western Isles. It is based on the statutory guidance Children and Young People (Scotland) Act 2014 and the subsequent Statutory Guidance on Part 3: Children’s Services Planning – Second Edition 2020, and covers all agencies, professions and staff working with children, young people and families | The document The document contains references to support systems in place for women who use drugs, and identifies these as a vulnerable group, with a focus on supporting substance misusing mothers, their children and young people and child safeguarding and protection | Perinatal period | Yes |
The Royal College of Midwives (2020) | Parental emotional wellbeing and infant development [88] | UK—wide | Specific profession / Community & Hospital | Midwives | Provides "information and advice on the inextricably linked issues of parental mental health, the parent-baby relationship, and infant development" | There is a specific section on alcohol and drug use during pregnancy | Perinatal period | Unclear |
Milton Keynes Inter-Agency Safeguarding Children Procedures (2022) | Parental Substance Misuse [89] | England | Regional/ Milton Keynes/ Any setting | Social care workers | This is safeguarding guidance aimed at professionals who come across children, including unborn babies, who have parents who use drugs | This document includes a relevant section on safeguarding procedures for PWWUD | Perinatal period | No |
Public Health England (2021) | Parents with alcohol and drug problems: adult treatment and children and family services [90] | England | National / Any setting | Directors of public health and commissioners and providers of adult alcohol and drug treatment and children and family services | Guideline "outlines the main issues for families affected by parental alcohol and drug problems and shows how services can work together to support them." | Applies as universal guidance around parents using drugs, only a few specific references to pregnant women | Perinatal period | Unclear |
Scottish Government (2020) | Perinatal & Infant Mental Health Programme Board 2020–2021 Delivery Plan [91] | Scotland | National/ Any setting | All practitioners working in perinatal and infant mental health | The program is working towards "perinatal and infant mental health services that are responsive, timely and address the changing needs of women and families throughout pregnancy and the early years of life." | The document contains references to PWWUD in relation to supporting mental health in the perinatal period | Perinatal period | No |
Sussex Partnership NHS Foundation Trust (2018) | Perinatal Mental Health: Prescribing guidance for trust prescribers and GPs [92] | England | Regional / Sussex / Community | G. P’s and other prescribing practitioners | Provide guidance to practitioners prescribing medications to women during pregnancy for mental health issues | There is a section dedicated to "medications for substance misuse" | Pregnancy | No |
NICE (2021) | Postnatal Care [93] | UK—wide | National/ Hospital | Healthcare Professionals, Commissioners and providers of maternity care | This guidance document outlines the routine postnatal care that women and their babies should receive in the first 8 weeks after the birth | This is universal guidance, and contains some relevant recommendations related to the postnatal care of women who use drugs | Postnatal period | No |
Dumfries and Galloway—– Strategic Pre-Birth Planning Group (2019) | Pre-birth assessment protocol for vulnerable pregnancies [94] | Scotland | Regional / Dumfries & Galloway / Community & Hospital | All agencies / practitioners providing care to pregnant women and their families | Aim of the protocol: "The overall aim of this protocol is to support professionals in undertaking holistic, needs led / person centred assessments for vulnerable pregnant women and unborn babies that will identify risks and lead to a timely, proportionate and appropriate response to minimise any risk factors / vulnerabilities identified." | Problematic substance misuse in pregnancy is identified as being a vulnerable pregnancy, and therefore the document is relevant to this population. There are also specific references and recommended treatment / actions for PWWUD | Pregnancy | Yes |
NICE (2010; 2018) | Pregnancy and complex social factors: a model for service provision for pregnant women with complex social factors [95] | UK—wide | National/ Hospital | Healthcare Professionals, Commissioners and providers of maternity care | This guideline sets out what healthcare professionals as individuals, and antenatal services, can do to address needs and improve pregnancy outcomes for vulnerable women | Guideline applies to all pregnant women with complex social factors; women who misuse substances are identified as one of four exemplar groups | Pregnancy | Yes |
NHS Lothian (2011) | Pregnancy and problem substance use [96] | Scotland | Regional / Lothian / Community | G. P’s | To provide guidance to G. P’s on providing care to women who use drugs during pregnancy | Whole document is specific to PWWUD | Perinatal period | No |
NHS Lothian Quality Prescribing Group Substance Misuse Directorate (2016) | Pregnancy Guidance [97] | Scotland | Regional/ Lothian/ Any setting | Substance misuse staff | The guidelines are to be used by substance misuse staff treating pregnant women with drug and alcohol problems | The whole document is relevant as it refers to the management and care of pregnant women who use drugs | Perinatal period | Yes |
Ministry of Justice and HM Prison and Probation Service (2021) | Pregnancy, mother and baby units (MBUs), and maternal separation from children up to the age of two in women’s prisons [98] | UK—wide | Specific profession / Prisons | Prison staff | An operational policy for mother and baby units in prisons | Universal document for all pregnant women and babies in prison, but also has specific sections on pregnancy and women who use drugs | Perinatal period | Yes |
Camden and Islington NHS Foundation Trust (2019) | Prescribing guidance for substance misuse services. [99] | England | Regional/ Camden and Islington/ Any setting | Healthcare practitioners working in substance misuse prescribing | Prescribing guidelines for workers in substance use services to promote evidence-based prescribing in line with national guidance (NICE and PHE) | The document contains a relevant section on prescribing guidance for pregnant opiate dependent clients | Perinatal period | Yes |
Department of Health, Social Services, and Public Safety (2020) | Preventing Harm, Empowering Recovery: A strategic framework to tackle the harm from substance use (2021–31) [100] | Northern Ireland | National / Any setting | Policy makers, service commissioners, service providers, practitioners, the public | National drugs strategy—includes aim to reduce stigma, increase access to and provision of high-quality treatment. Is outcome based | Universal document applicable to all who use substances—however they also identify high risk groups and name "vulnerable women and individuals in the pre- and post-natal period;" as one of these groups | Perinatal period | Yes |
Royal College of Obstetricians and Gynaecologists (2015) | Reducing the Risk of Venous Thromboembolism during Pregnancy and the Puerperium (2015) [101] | UK—wide | National/ Hospital | Obstetricians and midwives | Aims to provide clinical, evidence-based advice on the prevention of venous thromboembolism (VTE) during pregnancy, birth and following delivery. It subsequently aims to reduce maternal deaths | The document contains specific recommendations and risk assessment procedure for pregnant substance using women | Pregnancy | No |
Scottish Government (2018) | Rights, Respect and Recovery Scotland’s strategy to improve health by preventing and reducing alcohol and drug use, harm and related deaths [102] | Scotland | National / Any setting | Policy makers, service commissioners, statutory and non-statutory service providers and practitioners, people who use drugs and their families | Provides guidance on best approach to supporting people with drug / alcohol issues and aims to "reduce the use of and harm from alcohol and drugs, with a particular focus on reducing alcohol and drug deaths." | Universal and applicable to all people who use drugs but also contains a specific section on maternal and infant health | Perinatal period | Unclear |
Public Health England (2018) | Safeguarding and promoting the welfare of children affected by parental alcohol and drug use: a guide for local authorities [103] | England | National/Any setting | Local authorities (commissioners) and substance misuse services | "A guide for local authorities and substance misuse services to help them work together to safeguard and promote the welfare of children." | The document covers the safeguarding of children in family settings, and contains recommendations for PWWUD | Perinatal Period | No |
Rotherham Safeguarding Children Partnership (2015) | Safeguarding Children of Drug Misusing Parents [104] | England | Regional /Any setting | All practitioners working with children and families affected by problematic parental drug / alcohol use | Local safeguarding procedure manual advice for professionals where a parent is using drugs | Specific references to PWWUD throughout the document | Perinatal period | Unclear |
Cumbria, Northumberland Tyne and Wear NHS Foundation Trust (2019) | Safeguarding Children Practice Guidance Note Addiction Services—Pregnancy Pathway and Guidance – V02. [105] | England | Regional/ Cumbria, Northumberland, Tyne and Wear/Any setting | Substance misuse staff | Outlines the role of Cumbria Northumberland, Tyne and Wear NHS Foundation Trust (the Trust/CNTW) Substance Misuse Services and their procedure for working with women engaging in substance misuse services whilst pregnant | The whole document is relevant, focussing on pregnant women who use drugs and how the substance misuse services should support women and their babies throughout pregnancy and postnatally | Perinatal period | No |
South Gloucestershire Safeguarding Children Board (2015) | Safeguarding Guidance for Substance Misuse [106] | England | Regional / South Gloucestershire/ Any setting | Social care teams and substance misuse providers | Provide clear understanding of practitioner’s role in assessing and supporting parents where their parenting has been identified as being impacted by drug use | Universal and applicable to all parents who use drugs but also has specific sections and references throughout relating to pregnancy, maternal and infant care | Perinatal period | Unclear |
Rotherham Safeguarding Children Partnership (2016) | Safeguarding Unborn and Newborn Babies [107] | England | Regional/ Rotherham/Any setting | All staff working with children and families | The procedure is applicable to any practitioners who has identified a concern for an unborn baby and subsequently provides a framework for the appropriate safeguarding response and planning for practitioners, working together with families, to safeguard the baby at birth | The whole document is relevant as it covers the proceedings for pregnant women who have been referred to children's social care because their baby has been viewed as at risk, including for the use of significant substance use | Perinatal period | Yes |
NHS England (2019) | Saving Babies Lives Care Bundle v.2 [108] | England | National / Any setting | Service providers, commissioners and healthcare professionals | Aim is to provide guidance on how to reduce infant mortality | There are a few specific recommendations in relation to PWWUD | Perinatal period | No |
Shetland Child Protection Committee (2017) | Shetland Integrated Children's Services Plan [109] | Scotland | Regional/ Shetlands/ Any setting | All staff working with children and families | Set out strategic priorities, and aims to achieve the outcomes identified in the Shetland Partnership’s Local Outcomes Improvement Plan, Shetland’s Commission on Tackling Inequalities Report—On Da Level, and partner agencies Corporate Plans | The document highlights that PWWUD are included within the guidance as a group facing inequalities—therefore the guidance is relevant to them | Pregnancy | Yes |
Southwark Safeguarding Children Partnership (2020) | Southwark Joint Service Protocol to meet the needs of children and unborn children whose parents or carers have substance misuse problems [110] | England | Regional / Southwark / Any setting | All staff working with children and families | Aims to ensure that professionals are aware of their safeguarding duties for children and support them to identify children who may be at risk as a consequence of parental substance misuse | The whole document is relevant specifically referring to pregnant women who use substances throughout | Perinatal period | Unclear |
NHS Greater Glasgow & Clyde Alcohol and Drug Recovery Services Pharmacy Team (2019) | Standards for Drug & Alcohol Services in Community Pharmacies [111] | Scotland | Regional/ Scotland/ Community | Drug services & Community pharmacists | The guidance covers the prescribing and supervision of substitution therapy | The document contains references to the potential harms of detoxification during pregnancy and guidance related to opioid substitution therapies | Pregnancy | No |
North Yorkshire Safeguarding Children Partnership (2019) | Substance Misuse in Parents [112] | England | Regional / North Yorkshire / Any setting | All staff working with children and families | Support local operational arrangements between adult and young people’s drug and alcohol service providers and children and families’ services, to ensure effective safeguarding and joint working | The whole document is relevant as applicable to parents who use drugs and specifically refers to pregnant women | Perinatal period | No |
NHS Lothian—Anne Whittaker (2003) | Substance Use in Pregnancy [113] | Scotland | Regional/ Lothian/ Any setting | Professional and service providers working with women who use substances in pregnancy | To provide a framework and good practice guide for professionals supporting women who use drugs in pregnancy | The whole document is relevant to PWWUD | Perinatal period | Yes |
Hull Safeguarding Children's Partnership (2022) | Substance Misuse in Pregnancy [114] | England | Regional / Hull / Any setting | All professionals working with parents expecting a child who misuse substances | To provide guidance to practitioners working with PWWUD | The whole document is specific to how people should work to support women using drugs during pregnancy and advice they should be given | Perinatal period | Unclear |
University of Leicester Hospital Trust (2019) | Substance Misuse in Pregnancy – Guidance for the care of pregnant drug /alcohol users and their babies. [115] | England | Regional/ Leicester/ Hospital | Medical/Nursing staff | These guidelines are for community, maternity and neonatal staff to make sure that babies at risk of NAS are identified and receive proper care and management in the neonatal period | The whole document is relevant, as it outlines how midwifery staff should assess and support women who use drugs during pregnancy and babies at risk of neonatal abstinence syndrome | Perinatal period | No |
Heart Of England NHS Trust (2016) | Substance Misuse in Pregnancy (V.4) [116] | England | Regional / Heart of England / Any setting | All staff working within maternity (Obstetrics, Midwifery, Anaesthetics, Neonatologists) | Purpose of document is to provide guidance on providing "excellent care" to PWWUD and their babies to reduce "maternal and neonatal morbidity and mortality associated with substance misuse in pregnancy." | The whole document is specific to this population | Perinatal period | No |
Walsall Healthcare NHS (2017) | Substance misuse in pregnancy and subsequent care of the newborn [117] | England | Regional/ Walsall/ Hospital | Medical/Nursing staff | Provides written guidance for staff with regards to the correct procedures when caring for PWWUD. (inc. antenatal/postpartum) | The whole document is relevant | Perinatal period | Unclear |
Royal Cornwall Hospitals NHS Trust (2020) | Substance Misuse in Pregnancy, Labour and Post Delivery Clinical Guideline [118] | England | Regional / Cornwall / Hospital | All healthcare practitioners supporting pregnant women who use substances | "This guideline aims to create an environment where women with problematic drug or alcohol use will have the knowledge of and confidence in a team who manage them sympathetically in pregnancy and help to minimise harm to the woman and baby. 1" | The whole document is specific to this population | Perinatal period | No |
Frimley Health NHS Foundation Trust (2021) | Substance Misuse in Pregnancy: multidisciplinary guidelines for Frimley Health NHS Foundation Trust [119] | England | Regional/ Frimley/ Hospital | Medical/nursing staff | Outlines the clinical guidance related to women/families who use substance and their babies through partnership working with parents and multiagency collaboration | The whole document is relevant to PWWUD | Perinatal period | No |
Welsh Government (2011) | Substance Misuse Treatment Framework (SMTF) Guidance for Evidence Based Community Prescribing in the Treatment of Substance Misuse [120] | Wales | National / Community | Professional prescribing drug treatment medications | Provides best available evidence to inform decisions about community prescribing treatment options for people who misuse substances | Has a specific section for substance misuse in pregnancy | Perinatal period | Yes |
Birmingham Women and Children's NHS Foundation Trust (2021) | Substance Misuse: Management of Pregnant Women [121] | England | Regional/Birmingham/Hospital | Maternity/Neonatal staff | Gives guidance to nurses/midwives/doctors caring for PPWUD, are drug or alcohol dependent or in a drug treatment program | The whole document is relevant as it refers to the management of pregnant women who use drugs | Perinatal period | Yes |
Public Health England (2013) | Supporting information for developing local joint protocols between drug and alcohol partnerships and children and family services [122] | England | National / Community | Service commissioners, providers and practitioners in drug and alcohol services, and children and families’ services | This document outlines what should be in local protocols for safeguarding children in families affected by drug or alcohol misuse | There is reference and recommended practice in relation to pregnancy and substance misuse | Perinatal period | No |
Tayside Multi-agency Partnership (2021) | Tayside Multi-Agency Practitioner’s Guidance: Concern for Unborn Babies [123] | Scotland | Regional/Tayside/Any setting | Practitioners and service providers working with children | Provides practitioners and managers who might work directly or indirectly with children, young people and families with guidance on identifying and responding to concern about unborn babies | The generic guidance within the document is relevant to PWWUD as it highlights this group as a vulnerable population | Pregnancy | Yes |
NHS Ayrshire & Arran (2019) | The Management of High-Risk Pregnancies [124] | Scotland | Regional / Ayrshire & Arran /Any setting | All staff working within agencies who are members of all three Child Protection Committees in Ayrshire | To provide clear guidance to staff managing high risk pregnancies | The whole document is relevant as it specifies women who use substances during pregnancy are high risk category | Perinatal period | Unclear |
National Collaborating Centre for Mental Health (2018) | The perinatal mental health care pathway; Full implementation guidance [125] | England | National/Any setting | Mental health and social care providers | Introduces pathways outlining access to services for women with a mental health problem in the perinatal period, or with a history/existing mental health challenge who are planning a pregnancy | The document is universal guidance for perinatal mental health, and contains mention of the referral pathways from drug and alcohol services and contains recommendations for developing a care plan for this population | Perinatal Period | No |
Norfolk & Waveney NHS Trust (2021) | Trust Guideline for the Care of Vulnerable Women in Pregnancy [126] | England | Regional / Norfolk /Any setting | Maternity services | To encourage the use of specialist services to support vulnerable women in pregnancy | The whole document is relevant as it specifies women who use substances during pregnancy are a vulnerable category, there are also specific recommendations for their care | Perinatal period | Yes |
Hull Safeguarding Children's Partnership (2022) | Unborn Procedures and Guidance (Pre-Birth Pathway) [127] | England | Regional/Hull/Any setting | All staff working with children and families | The guidance has been designed by a multi-agency group, with the aim of developing a consistent Pre-Birth Assessment Pathway which identifies vulnerability early and provides a clear pathway into appropriate support services | The document is generic, but contains references to women who are pregnant and have substance misuse problems both within the guidance and in a dedicated section within the appendix | Perinatal period | Yes |
Scottish Government (2015) | Universal Health Visiting Pathway in Scotland: Pre-birth to Pre-school [128] | Scotland | National / Community | Health visitors | Outlines the health visitors' role and schedule of care | Document is applicable as universal to all pregnant women, new mothers and babies. Recognises substance misuse by mother as category of vulnerability and makes a few specific recommendations for their care | Perinatal period | Yes |
East Ayrshire Child Protection Committee (2017) | Vulnerable Pregnancy Procedure [129] | Scotland | Regional/East Ayrshire/Any setting | Healthcare professionals, especially those working with pregnant women and their babies | Aims to support practitioners conducting a needs led and person-centred assessment of vulnerable pregnant women, her partner and unborn babies that will identify strengths and risks. The assessment should be followed by a timely and proportionate response to any needs or risks identified | The whole document is relevant as problematic substance misuse—of either parent is listed as an identifying factor of a vulnerable pregnancy, however it does not contain specific recommendations for PWWUD | Perinatal period | Yes |
West Yorkshire Consortium Inter Agency Safeguarding and Child Protection Procedures (2022) | West Yorkshire Consortium Inter Agency Safeguarding and Child Protection Procedure 1.4.15 Children of Drug Misusing Parents [130] | England | Regional / West Yorkshire /Any setting | All staff working with children and families | This is a child protection procedure for staff to follow in the assessment of safeguarding issues where a parent misuse substances | The procedure relates to all parents who use drugs including women who are pregnant or have just had a baby. There are also specific references to drug use in pregnancy and a section relating to this | Perinatal period | Unclear |
Highland Council & NHS Highland (2019) | Women, Pregnancy and Substance Use: Good Practice Guidelines [131] | Scotland | Regional/Highlands/Any setting | Maternity services/Health and social care services | This guidance document represents best practice for maternity staff across Highland but notes that this is also applicable to other services involved with pregnant women who use substances | The whole document is relevant, as it outlines how midwifery services, and any other associated drug/alcohol services should care for PPWUD | Perinatal period | Yes |
UK Government (2018) | Working Together to Safeguard Children A guide to inter-agency working to safeguard and promote the welfare of children [132] | England | National / Any setting | All staff and agencies working with children, and families; all local authorities, clinical commissioning groups, police and all other organisations and agencies | This document sets out legal child protection responsibilities of all agencies | The whole document is relevant as universal to all babies, and children. There are specific references to substance misuse in pregnancy, and more generally under the definition of neglect provided in the Appendix | Perinatal period | No |
Derbyshire Safeguarding Children Board (2022) | Working with parents who are misusing substances [133] | England | Regional/ Derbyshire/ Any setting | All staff working with children and families | The protocol aims to ensure that all unborn babies have their needs identified and met as swiftly as possible to ensure that appropriate and timely services are delivered in an integrated manner | The document contains relevant sections on parental substance misuse and a Pre-birth Assessment Pathway for substance misuse | Perinatal period | No |
Aberdeen City Child Protection Committee (2017) | Working with vulnerable unborn babies and their families multi-agency practice guidance [134] | Scotland | Regional / Aberdeen/ Any Setting | All staff working with children and families | Child protection guidance to support staff to be aware of impact of range of complex social circumstances (including substance misuse) on pregnancy and infants, identify unborn babies at risk, know their legal obligations and what action to take, and support them to share information appropriately | The whole document is specific to women who use drugs during pregnancy—as well as other identified factors that may place an unborn baby at risk of harm and require specific supports and interventions | Perinatal period | Unclear |
World Health Organization (2014) | Guidelines for the identification and management of substance use and substance use disorders in pregnancy [135] | UK—wide | International/Any setting | All healthcare practitioners supporting pregnant/postnatal women who use substances | Provides evidence-based technical advice for healthcare providers regarding the management of substance use in pregnancy and facilitates healthcare practitioners’ application of "scientific principles of a public health approach" in their own national/local settings | The whole document is specific to women who use drugs during the perinatal period and postnatally | Perinatal period | Yes |