References
Exploring safeguarding midwives' experiences of caring for pregnant women with substance dependency

Abstract
Background/Aims
Midwifery research exploring midwives' views and beliefs about pregnant women with substance dependency has centred on those working in clinic or hospital settings. There is little research exploring the relationship between these women and safeguarding midwives providing clinical care via a community-based midwifery-led continuity of care model. This study aimed to explore this relationship.
Methods
Using interpretative phenomenological analysis and visual inquiry techniques, five midwives participated in semi-structured interviews exploring their attitudes and emotions about working with women with substance dependency.
Results
Five superordinate themes were found: transformation, tug of war, reciprocity, proxy parenthood and the midwives' twitch
Conclusions
Midwives' relationships with women with substance dependency are based on partnership, honesty, trust, care and compassion. Midwives' perceptions of these women were transformed through reciprocal relationships facilitated by midwifery-led continuity of care and the women's life stories.
Implications for practice
Midwifery-led care models should be expanded to include women of all risk levels. Additionally, women's narratives should be included when educating student and qualified midwives about substance dependency in pregnancy.
There are gender differences in how society views substance use, with women often being viewed more harshly than men (Ettorre, 2015). This unsympathetic view amplifies when women are pregnant, leading them to be perceived as morally corrupt, scheming and dishonest (Miles et al, 2012; Ettorre, 2015). The societal expectations of ‘the good mother ideal’ can lead to the stigmatisation of women (Nichols et al, 2021), as they are viewed as unable to fulfil their role as good mothers (Weber et al, 2021). This view can be unwittingly reflected in the care provided to women, as some healthcare professionals, including midwives, may find it challenging to distance themselves from negative ingrained attitudes (Nichols et al, 2021). The European Union Drugs Agency (2023) suggests that along with a fear of having their babies removed from them, these attitudes can deter women from seeking help with their addictions.
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