Balancing Between Hope and Realism: Exploring Professional Accounts of the Transition Into Parenthood of Pregnant Women Who Use Substances

Pregnancy for women who use substances has sometimes been referred to as a “window of opportunity” for lifestyle change. In this article, the aim is to analyze professional accounts of the transition of substance-using pregnant women into parenthood. Focus groups were carried out with professionals working at specialized maternity care units in Sweden. The analysis is guided by the discursive psychological concept of “ideological dilemma” and focuses on contradictory elements of commonsense-making in the participants’ discussions. The results suggest that professionals articulate two, partly contradictory, ideals: on the one hand, “believing in the patient” and, on the other, “being realistic.” In their descriptions of their work with patients, professionals emphasize the significance of adjusting the self-image of the patients and increasing their awareness of their “abuse” problems in order to prevent future clashes between high expectations and reality. At the same time, they also underline that interacting with and treating those patients with the most serious problems as individuals with unforeseen strengths and resources is a matter of professional duty