Labor and Delivery Nurses' Perceptions of Their Colleagues' Attitudes and Behaviors Toward Pregnant Patients with Substance Use

Objective:To understand labor and delivery nurses' attitudes and behaviors toward pregnant patients with substance use disorders or mental health concerns. Suicide and overdose are among the leading causes of preventable maternal deaths nationwide, underscoring the urgency of addressing issues related to supporting pregnant patients with behavioral health concerns.Design:We surveyed a subpopulation of nurses in Colorado to understand attitudes and behaviors toward patients with substance use disorders and mental health concerns.Results:Survey respondents were 154 nurses from 14 Colorado hospitals that represented 45% of the state's 2022 births: Half of the nurses reported their colleagues have negative attitudes and nearly one-third reported negative behaviors toward patients who disclose substance use. Qualitative data revealed instances of positive behaviors, with examples of supportive clinical care and resource provision for patients disclosing substance use. Negative examples described mistrust, negative attitudes, and lack of compassion toward patients, as well as instances of substandard clinical care.Conclusions:In this study, negative attitudes and behaviors were noted by some labor and delivery nurses by their colleagues toward pregnant patients with substance use disorders. Positive behaviors were also reported. Comprehensive processes to decrease negative behaviors are necessary to improve care for pregnant patients and to decrease maternal mortality from suicide and accidental overdose.