P7. Ask them all: Self-report universal prenatal substance use screening in the United States

About The Event

Learner category:

  • Novice Level
  • Intermediate Level

Learning objectives:

  • Participants will identify two barriers to effective intervention and family support in caring for women experiencing prenatal substance use disorders.
  • Participants will identify two strategies to reduce barriers to effective collaboration, intervention, and support in caring for pregnant women affected by substance use disorders


Problem Increasing rates of opioid use in the United States have created a national public health crisis. National advisory groups recommend screening all women for prenatal substance use. However, there is no single approach or tool recommended. Early screening for maternal substance use assists in identification and opportunity to engage women in a supportive plan of care. Issues related to substance use disorders are often multifactorial including a history of trauma, adverse childhood experiences, overall dysfunction in multiple domains, and stigma. Barriers to seeking care can be significant. Reducing stigma through universal prenatal screening practices provides opportunity to address barriers and improve collaboration. Objective This study seeks to evaluate the effectiveness of universal prenatal screening self-report of substance use in pregnancy. Method: A retrospective data review reflecting 24 months of maternal selfreports was completed. The screening questionnaire utilized standard 4 P’s Plus with an additional fill in question on substance(s) of choice and time of last use. Women completed questionnaires at the first prenatal visit and admission for childbirth. Women with positive self-reports received brief intervention and were offered referral for treatment. Results: N=1472, with 3,309 screens administered during a 24-month timeframe. Positive self-report n=143 (9.7%). Opioids: n=94 (66%). Marijuana: n=47 (33%). Benzodiazepines: n=26 (18%). Methadone/ buprenorphine n=23 (16%). Findings revealed prenatal report of substance use higher than the 5.4% United States national average. Conclusion Findings suggest the direct method supports maternal self-report of substance use through universal prenatal screening. Additional study with diverse populations and clinical settings is needed.


Kathleen Elertson, DNP, APNP, CPNP, FNP-BC University of Wisconsin Oshkosh College of Nursing, USA
Dr. Kathleen Elertson is a tenured, associate professor at the University of Wisconsin Oshkosh College of Nursing in Oshkosh, WI, USA. Dr. Elertson has extensive background in prenatal substance use disorders and neonatal withdrawal syndrome. Dr. Elertson holds dual advanced practice certification in pediatrics and family practice. In addition to teaching, Dr. Elertson is engaged in active clinical practice.
Dr Catherine Schmitt, PhD, CNOR, RN University of Wisconsin Oshkosh College of Nursing, USA
Dr. Catherine Schmitt is a tenured associate professor at the University of Wisconsin College of Nursing in Oshkosh, WI, USA. Dr. Schmitt has an extensive history in nursing with a focus on preparing and mentoring nurses for practice. Dr. Schmitt has significant experience in the identification of prenatal substance use disorders.

Our Speakers

Dr Catherine Schmitt
Kathleen Elertson
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