Kvinnan och det väntade barnet - Etiska dilemman i arbetet med graviditet och missbruk

Abstract

Background: This study is about women using drugs or alcohol during pregnancy. Focus in the study is to explore healthcare counsellors experience and challenges in their work with the mothers to be. The study highlights the counsellors work with the pregnant women’s perspective (supporting the mother to be) versus the unborn child’s perspective (protecting the child to be). The theoretical approach is ethical dilemmas and different ethical positions. Method: The study has a qualitative approach. Data has been collected by semi structured interviews with six healthcare counsellors, working with pregnant women having some type of substance abuse. Results: The counsellors are supporting the woman through her social situation. They support and help her in the ambivalence struggles that the pregnancy can bring, such as to keep the baby or have an abortion. It is also important that they work together with other professions to make sure she gets all the help she needs and that everyone works in the same direction. The counsellors have to work against resistance and sometimes motivate the women to come to them. When the addiction is too heavy and the woman can`t stop using drugs despite her pregnancy, the counsellors have to work in different ways to make sure that the fetus is as safe as possible and at the same time continue to support the woman. Conclusion: The study identified that the challenges are many and the dilemmas are constantly present in one or another way. It is not enough that the woman is tested for drugs once a week, it is a false control to think so. Even if the counsellors have to work both with the alliance to the woman and the support of the fetus, there is no question that the safety of the fetus weighs heavier than the relationship with the mother to be.