title: Complicating the dominant morality discourse: mothers and fathers' constructions of substance use during pregnancy and early parenthood.
abstract: BACKGROUND
  Consumption of substances is a highly controversial behaviour, with those who do so commonly viewed as deviants, even criminals, or else as out of control addicts. In other work we showed that the use of substances by women who are pregnant or have recently become parents was mainly viewed by health and social care providers as morally wrong. Problematic substance use was framed through the narrow lens of gendered responsibilisation, resulting in women being seen primarily as foetal incubators and primary caregivers of infants.
  
  
  METHODS
  In this follow-up paper we examine descriptive and qualitative data from a convenience sample of biological mothers and fathers (N = 34) recruited as part of a larger mixed methods study of the development and early implementation of an integrated primary maternity care program. We present a description of the participants' backgrounds, family circumstances, health status, and perception of drug-related stigma. This is succeeded by a thematic analysis of their personal views on substance use during both pregnancy and the transition to parenthood.
  
  
  RESULTS
  Our results show that while many mothers and fathers hold abstinence as the ideal during pregnancy and early parenting, they simultaneously recognize the autonomy of women to judge substance use risk for themselves. Participants also call attention to social structural factors that increase/decrease harms associated with such substance use, and present an embodied knowledge of substance use based on their tacit knowledge of wellness and what causes harm.
  
  
  CONCLUSIONS
  While these two main discourses brought forward by parents concerning the ideal of abstinence and the autonomy of women are not always reconcilable and are partially a reflection of the dissonance between dominant moral codes regarding motherhood and the lived experiences of people who use substances, service providers who are attuned to these competing discourses are likely to be more effective in their delivery of health and social services for vulnerable families. More holistic and nuanced perspectives of health, substance use, and parenting may generate ethical decision-making practice frameworks that guide providers in meeting and supporting the efforts of mothers and fathers to achieve well-being within their own definitions of problematic substance use.
authors: Centre for Addictions Research of BC and Department of Sociology, University of Victoria, PO Box 3050, Victoria, V8W3P5, BC, Canada. cbenoit@uvic.ca.
authors: Cecilia
authors: C
authors: Benoit
authors: School of Public Health and Social Policy, University of Victoria, PO Box 1700, Victoria, V8W2Y2, BC, Canada. samagnus@uvic.ca.
authors: Samantha
authors: S
authors: Magnus
authors: Centre for Addictions Research of BC, Centre for Addictions Research of BC, Victoria, Canada. rachelph@uvic.ca.
authors: Rachel
authors: R
authors: Phillips
authors: School of Nursing, University of Victoria, PO Box 1700, Victoria, V8W-2Y2, BC, Canada. lenoram@uvic.ca.
authors: Lenora
authors: L
authors: Marcellus
authors: Faculty of Law, University of Toronto, #1- 328 Arlington Ave, Toronto, M6C2Z9, ON, Canada. sinead.dearman@mail.utoronto.com.
authors: Sinéad
authors: S
authors: Charbonneau
mesh_terms: D000328:Adult; D055030:Drug Users; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009014:Morals; D011247:Pregnancy; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D055815:Young Adult