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Hepatitis C diagnosis ‘just one of
those things’ for many women
ASK MANY WOMEN
with hepatitis C
about their newly diagnosed status, and
they will say ‘it’s just one of those
things’, according to Anna Olsen of
Australia’s
National
Centre
for
Epidemiology and Population Health.
For many of the 109 women inter-
viewed for a study on attitudes towards
living with the disease, getting hepatitis
C ‘confirmed their identity as a drug
user’ because they saw it as inevitable. ‘I
felt like a walking disease for a while,’
reported one.
‘But this doesn’t mean they didn’t care
about their bodies, their futures, their foetuses or their children,’ said Ms Olsen.
Fewwomen were found to be accessing specialist care, but they were found to
be keen to discuss bigger problems in their lives that eclipsed hepatitis C.
Gaining and maintaining stable housing, a regular income, and care and
custody of children were seen as more pressing issues. One teenager revealed
she had been farmore concerned about finding out that shewas pregnant than
the news that she had hepatitis C.
‘Many are already living a lifestyle that’s stressful and uncertain,’ said Ms
Olsen. ‘They reel off a list and hepatitis C is at the end.’
Although they might feel marginalised, the women were not isolated
from other shaping forces. Many showed guilt, particularly those who had
experienced intervention from social services in removing their children.
Some assumed drug use had damaged their ability to have children before
finding themselves pregnant.
It was important to recognise that many of the women ‘endeavour to
achieve good motherhood and have the same fears and hopes,’ said Ms Olsen.
Pregnancy was often seen as a chance to redeem themselves, she added,
motivating themto stop drug use ‘for the sake of the baby if not for themselves’.
Wednesday 28 April 2010 – DAY THREE –
Daily Update
– 5
‘A POLITICAL WAR
has been fought over
bodies of pregnant women,’ Jill Harris of the
Drug Policy Alliance told delegates in the
session on gender issues in harm reduction.
Punitive policies in many countries were
criminalising women for daring to use drugs
while pregnant,’ she said.
Much of the scaremongering was based
on misinformation on the risks to foetal health
which were often ‘exaggeration and myth’.
‘The healthcare systems gets turned on
its head when health professionals become
agents of law enforcement,’ said Ms Harris.
‘Women are made to feel they’re doing a
terrible thing, daring to be pregnant at the
same time as taking drugs, so they are
deterred from seeking care and seeing their
doctors.’
An ongoing legal case in Mississippi
demonstrated why women were afraid to seek
medical help. The woman who was now the
subject of legal action had become pregnant at
15 years old, had consented to a drug test
arranged by her doctor, and tested positive for
cocaine. She was told she needed to stop
taking drugs but was not referred for any
treatment, so continued to use. When her baby
was stillborn and traces of cocaine were found
through the autopsy, she was charged with
murder – a case that was being challenged as
inappropriate to be heard in court.
‘In this case there is no proof of the link
between cocaine use and stillbirth,’ said Ms
Harris. Alcohol and tobacco were found to
cause significantly higher harm than cocaine,
she said, and the myth around ‘crack babies’
a few years ago – the theory that babies born
to crack-using mothers had a lower IQ – had
been debunked by studies that showed much
less long-term harm to these children than
previously thought.
Foetal care should depend on giving
adequate healthcare and health insurance to
pregnant women instead of prosecuting and
criminalising them, she said.
Pregnant women ‘deserve healthcare not criminalisation’
Women’s services ‘must
be gender-sensitive’
INCREASING RATES OF DRUG USE
among women in
Eastern Europe and Central Asia have led to more demand
for gender-sensitive treatment, said Sophie Pinkham of the
Canadian International Development Agency. Women now
made up nearly half of new HIV cases in Russia and
Ukraine.
Many services had been designed with men in mind and
had no space for the ‘broader holistic elements’ that
women wanted, said Ms Pinkham. Women who had
experienced trauma from sexual and physical violence
could find the atmosphere ‘alienating and overwhelming’.
‘You can understand the dynamics of their situation when
you talk to them alone,’ she said.
Lack of knowledge, skills and resources within services
meant many staff could not begin to tackle the barriers
around stigma and fear. Many women were deterred from
seeking help because they felt guilty for using drugs in
pregnancy and felt stigmatised. Others were worried about
the intervention of childcare services.
A training programme was being developed with
support from the World Health Organization to give a four-
day flexible module in English and Russian, helping develop
services that were better suited to gender needs. Harm
reduction issues covered by the training would include
domestic violence, sex workers who use drugs,
methamphetamines and sexual risk behaviour, and drug
treatment and pregnancy.
The training would also address misconceptions: ‘Quite
often advisors don’t understand the use of methadone and
think it will cause damage to a foetus,’ said Ms Pinkham.
The module would be piloted in Russia, then added to
WHO’s harm reduction knowledge hub. More information at
www.harm-reduction.org
Anna Olsen:
Pregnancy is often
a chance for redemption.