Motivational other hand, negative attitudes of HCP’s

             Motivational Interviewing seems benefits for clients to reduce prenatalalcohol use. It has same effects of in-person interviewing. Some other methodsare counseling, screening methods, and increase the knowledge about the consequencesof substance abuse through multimedia and other educational materials.Behavioral therapy is an effective method for smoking cessation. Most of therandomized clinical trial studies not recommending pharmacologicalinterventions due to the safety and efficacy of pregnant and postpartum stages.Nicotine replacement therapy has limited effect on the rates of abstinence. Themost successful management for substance abuse is contingency management withfinancial incentives.

Breast feeding is another non-pharmacologicalintervention. It helps mothers to rethink about to continue smoking because itadversely affect their babies. Therefore, promotion of breastfeeding is helpfulto prevent or delay postpartum relapse. Another important benefit is duringlactation oxytocin hormone is producing largely it helps to reduces stress whichis one cause of addiction. Moreover, oxytocin is helpful for cognitive andmotor development for an infant, and increase skin-to-skin intimacy between momand baby, through this we can protect the fetus from the development ofaddictive and other problematic behaviours. Frequent visits during pregnancywill helpful for the physician to identify any relapse will happen in-between.Collect urine sample on each visit too.

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Rehabilitation services, frequenteducational programs, individual and family counseling also help her towithdraw from substance use.             On the other hand, negative attitudes of HCP’sand their response will cause individual withdraw from seeking medical attention. So here our team involved jack in hertreatment plan according to her needs, made a therapeutic relationship with herand provided special care referred her to another resource for detailed examination.Participation of multidisciplinary team is better than the individual plan ofcare. Everyone’s decision should be supportive and non-judgemental to her.

Regular meeting and discussion with her willgive more security to her thus the prognosis will be easier than formal visits.The role of the nurse is very important. They are the first person in contactwith women who are using the substance. So, the initial relationship is veryimportant. While taking all the medical and social history they can provideadequate information regarding various facilities available in the community.Provide enough information regarding next appointment or and other referralthey needed for this will helpful for the client to develop a more therapeuticrelationship with midwife/HCP.

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