Dr. Marilyn Lewis and partners in the College of Medicine are interested in improving outcomes for children born to pregnant women with a history of alcohol and other drug abuse through the use of contingency management (CM) prize reinforcement intervention strategies. Evidence suggests that decreasing drug use and increasing prenatal clinic attendance is critical for improved pediatric outcomes. Pregnant substance-abusing women who comply with CM treatment that reinforces abstinence are more likely stop drug use and deliver heavier babies (Jones, Svikis, & Tran, 2002). Svikis and colleagues (1997a) found that among pregnant women who did not receive drug treatment 26% delivered infants who required NICU hospitalization, compared to 10% who received treatment; and their infants remained in the hospital longer than infants whose mothers received treatment. Earlier work undertaken by Dr. Lewis indicated that pregnant women who had used drugs prior to pregnancy recognition and then decreased their substance use had stronger levels of maternal-fetal bonding than women who never used drugs or alcohol and therefore never needed to decrease their use (Lewis, 2002).
Dr. Lewis speculates that the ongoing conscious decision to avoid substance use reinforced the strength of the maternal-fetal bond. There are, however, no known studies examining whether systematic reinforcement of pregnancy-related activities enhances the maternal-fetal bond but earlier work suggests that reinforcement of activities in a specific life domain improves functioning in that domain (Lewis & Petry, 2005). In a retrospective study of cocaine-abusing adults who had been randomized to a 12-week CM intervention, participants who self-selected to engage in family activities had better treatment outcomes and improved family functioning than participants who did not engage in family activities. Participants who chose to earn CM reinforcement for engaging in family activities reported greater reduction in family conflict, even though both groups had reported similar levels of conflict at intake. Dr. Lewis and her colleagues are planning research aimed at examining whether CM reinforcement to increase pregnancy-related activities can strengthen a pregnant woman’s emotional bond to her fetus. Findings from this important work will provide valuable information about potential interventions targeting at-risk pregnant women in order to improve outcomes for their babies.
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