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

Poster 7

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

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


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
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.
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.

Comments (2)


    thank you for your presentation. Approx 15 years ago I worked on a perinatal addiciton prevention project in New Jersey we utilized Ira Chasnoff 4 P’s Plus for screening pregnant women.We provide prenatal providers a directory of tx providers who specifically treated pregrant women and we also served as a resource for prenatal providers.

  2. Virginia Singer

    Thank you. Very informative

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