Harm Reduction | Gender & Sexuality | Perinatal Substance Use

BCAPOP believes that harm reduction is an essential public health strategy to reduce the harms experienced by perinatal people who use substances.  Harm reduction is cost effective and aims to reduce the health, social, legal, cultural, and economic inequities associated with substance use.

• Harm reduction is evidence-informed and is based on best and promising practices.
• Harm reduction includes a continuum of services and strategies to empower individuals, families and communities to experience improved health outcomes.
• All perinatal people should have access to harm reduction services, supplies and programs.
• Harm reduction, including the decriminalization of drugs and reducing the stigma of substance use, reduces barriers to accessing services for perinatal people and improves health outcomes.
• We recognize the long-term effects of colonization and the need to respect Indigenous peoples’ care needs in a culturally safe way, including those related to substance use and harm reduction.

BCAPOP believes that gender identity is each person’s internal and individual experience of gender. It may include their sense of identifying with being a woman, man, nonbinary, transgender, or anywhere on the gender spectrum. BCAPOP also supports all individuals to self-identify their own sexual orientation; not limited to heterosexual, lesbian, gay, bisexual, questioning, asexual and two-spirited.

BCAPOP supports various definitions of family which include but are not limited to heterosexual parented, same sex parented, transgendered parented, married, unmarried, cohabitating, separated or divorced, and single. We recognize that there are intact families, blended families, families by choice, foster families and temporary caregivers, adoptive families, extended and multi-generational families.

BCAPOP believes that all perinatal people who use substances or have used substances in the past deserve equitable access to services that are free from judgement and stigma.  BCAPOP supports the following nine Guiding Principles in working with perinatal people who use or have used substances:2

1. Equitable access – Participants deserve equitable service regardless of location. We must work towards removing barriers so that participants may receive the supports when and where they need them.
2. Trauma & violence informed - Working in a trauma-informed way means creating a sense of safety and trust between staff and participants. Pregnant people who both use substances and have a history of trauma have likely experienced relationships where power was abused, and trust was broken. Trauma-informed services encourage opportunities for working collaboratively with people. They emphasize the fostering of choice and connection within the parameters of services provided.
3. Indigenous cultural safety - Cultural safety aims to create a culturally safe environment which enables people to receive care in ways supportive of their cultural strength, as opposed to stereotypical thinking, racism, and discrimination. Culturally safe health care practices promote respect and decolonization.
4. Harm reduction based – These strategies are non-judgemental and should support participants on any point of the spectrum from active use to abstinence. These approaches should help to reduce harm to the participant’s health and reduce the negative consequences of their substance use.
5. Participant centred & participant voices – The participant guides the decision making, creates their own goals and self-determination. Participant voices ensure that participants with lived and living experience are empowered and contribute to systems of care.
6. Recovery orientated - Recovery is personal journey for the participant and may include a menu of substance reduction strategies, abstinence, and/or safety planning options.
7. Parent-baby togetherness – We advocate to keep families together and to reduce the number of child removals experienced by participants and their infants. Parent and baby should be together as much as possible after birth by rooming in, promoting skin-to-skin contact, breast/chestfeeding, and familiarity through all the senses. Every parent and child have the right to visitation and to build a relationship with each other after birth and beyond.
8. Interdisciplinary - Working with interdisciplinary teams identified by the participant acknowledges how healthcare professionals and social service providers from different disciplines and peers can collaborate with a common purpose to set goals, make decisions, share resources and responsibilities.
9. Evidence informed – Refers to being guided by quality research evidence, clinical practice guidelines, leading practices, and Indigenous ways of knowing. This also includes current evidence-based information regarding the effects of substances on the pregnant individual, their fetus, and their baby. In order to reduce stigma, it’s important to share the truth about the effects of substance use during pregnancy and to also combat myths.