Preventing Smoking & Exposure to Secondhand Smoke Before, During, & After Pregnancy
Centers for Disease Control & Prevention
What is Third-hand Smoke? Is it Hazardous? (Scientific American, 2009)
Bulk copies of the U.S. Department of Health and Human Services brochures (referenced on the Educational Materials: Safe Sleep webpage) may be ordered though the National Institute of Child Health and Human Development.
Materials can also be ordered from the Safe to Sleep Public Education Campaign website.
Prenatal Substance Use Reporting Law and Resources
Reporting Law Modification
Effective Date: August 1, 2010
Reporting of prenatal alcohol and marijuana use to local welfare agencies is no longer mandated for certain service providers
Who is exempt from reporting?
Health care and social service professionals providing prenatal care or other health care services during pregnancy.
The law defines prenatal care as the comprehensive package of medical and psychological support provided during pregnancy.
Why was the law changed?
The law was changed to create a safer environment for pregnant women to disclose and address their alcohol and marijuana use.
Focus groups conducted in the Twin Cities revealed that many women delayed entry into prenatal care because they feared that they might lose their babies if they were reported for substance use. They stated they wanted to talk openly with their health care providers about their alcohol or drug use in a safe setting and get help to quit.
Substance-free pregnancies can best be promoted within the context of a trusting relationship with a prenatal care provider. Providers can now tailor their messages about alcohol and marijuana cessation to individual needs and reinforce these messages at each prenatal visit. They can explain the risks and provide resources and support to deal with the many stressors women confront. Providers can refer women for an assessment if needed, or if they feel that their county program is the best option for an individual, they may make a voluntarily report.
How can I respond effectively when pregnant women acknowledge alcohol or drug use?
Brief interventions have been tested in health care settings and found to reduce substance use.
Brief interventions can be as simple as a few sentences: Stating concern about the individual's alcohol or marijuana use. Describing how the use may cause harm. Advising to stop or reduce use.
Other approaches recommend sharing screening results and providing recommendations about abstaining from alcohol and drug use during pregnancy. Asking patients/clients for their views about their use and listening carefully. Providing medical advice and negotiating options to pursue including developing a goal and an action plan.
A variety of helpful brief reports, manuals and free online trainings are available that describe these techniques. Although these typically focus on alcohol use, the techniques are also appropriate for marijuana use.
Screening for Alcohol Use & Alcohol-Related Problems (NIAAA Alcohol Alert #65)
Systematic screening for alcohol use during pregnancy can identify women whose drinking may be harmful to the fetus even if they are not dependent on alcohol. Includes information on brief screenings that can be done in primary care and prenatal care settings.
Brief Interventions (NIAAA Alcohol Alert #66)
Brief interventions are an effective way to reduce drinking, especially among people who do not have serious problems. Describes brief interventions and the supporting research on their effectiveness.
Screening and Brief Intervention for Unhealthy Alcohol Use (Centers for Disease Control and Prevention)
Provides a step-by-step guide for implementation of brief intervention procedures consistently in a practice setting. Although designed for trauma centers, the information is applicable in health care settings as well. The information on pages 17-19 is especially helpful.
Helping Patients Who Drink Too Much (NIAAA)
A comprehensive guide for clinicians using a 4-step model: Ask about alcohol use. Assess for alcohol use disorders. Advise and assist (brief intervention). Follow-up and continued support.
Information on Coding for Reimbursement
Substance Abuse and Mental Health Services Administration has a website on Comprehensive information on Screening, Brief Intervention, Referral and Treatment (SBIRT), including specific tools and information on coding for reimbursement.
Online Training Options
Alcohol screening and brief intervention curriculum from Boston Medical Center and Boston University that uses the 5 A's (Ask, Assess, Advise, Arrange, and Assure), a patient-centered, evidenced-based approach.
Med Student Learning offers a CME course on screening, brief intervention and referral.
For information on the prevention of Fetal Alcohol Spectrum Disorders and to learn more about grant opportunities for your clinic to implement consistent prenatal alcohol screening, visit the Minnesota Organization on Fetal Alcohol Syndrome (MOFAS) website.
Last updated May. 9, 2013