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Stigma in Notes Hinders Substance Disclosure in Pregnancy

September 16, 2025
in Medicine
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Pregnancy is often regarded as a critical time for expectant mothers, with their health and well-being taking center stage. However, the complexities surrounding substance use during pregnancy have been increasingly scrutinized. A recent study led by researchers, including Sharko, Ancker, and Sharma, sheds light on an alarming issue: pregnant patients are less inclined to disclose substance use if they sense stigma within their clinic notes. This finding is a crucial puzzle piece in the broader discourse on maternal health, mental health, and the effects of societal stigma on health disclosures.

Stigma can be manifold in healthcare settings; it often manifests through negative attitudes, misunderstandings, or assumptions about individuals who engage in substance use. This stigma not only affects the pregnant individuals but can also generate wider implications for the health system at large. The fear of being judged may prevent pregnant patients from being transparent with healthcare providers, thus leading to compromised healthcare interventions and support systems tailored for them.

In their study, the authors meticulously gathered data on the intersection of stigma, privacy concerns, and substance use disclosures. They aimed to understand the factors that influence pregnant women when deciding whether or not to reveal their substance use history during prenatal care. The idea was to grasp the extent to which perceived stigma could limit honest conversations about substance use, potentially endangering both maternal and fetal health outcomes, and the healthcare context in which these discussions take place.

The results were striking. Researchers identified a significant correlation between perceived stigma in clinical documentation and the likelihood of pregnant patients disclosing their substance use. This revelation is particularly concerning, as it emphasizes an inherent distrust in the healthcare system among vulnerable populations. Their worry is not unfounded; studies have shown that stigmatization can lead to increased feelings of isolation, anxiety, and depression, especially for pregnant individuals grappling with substance dependence.

What must be understood is the mechanism behind this stigma perception. Often, clinic notes contain language that can be clinical and detached, but may also unintentionally convey bias or moral judgment. For example, terms like “addict” or phrases that indicate moral failing can inhibit patients from being open about their substance use in fear of being labeled or ostracized. The researchers poignantly highlight that such language could be a barrier to effective communication and care, demonstrating that even well-meaning practitioners may inadvertently contribute to a culture of stigma.

The implications of these findings are profound. They suggest that healthcare providers must reassess the language they utilize in both clinical notes and patient interactions. Shifting towards a more inclusive and supportive dialogue could foster an environment where pregnant women feel safe and encouraged to share their substance use experiences. This paradigm shift is essential for improving maternal health, as undisclosed substance use can lead to a range of issues, from inadequate prenatal care to adverse neonatal outcomes.

However, enacting change is not merely a matter of altering terminology; it also requires training and education for healthcare providers. Emphasizing empathy, understanding, and non-judgmental attitudes can pave the way for more effective patient-provider relationships. Providers’ awareness of the potential for stigma in their interactions can facilitate a more patient-centered approach.

Furthermore, the researchers discussed the importance of systemic changes in healthcare settings to protect patient privacy and build trust. Heightened attention to confidentiality in medical records and a commitment to safeguarding sensitive information are vital components of this process. When patients know that their information will be treated with the utmost respect, they may feel empowered to disclose critical details about their health and well-being.

In light of this study’s findings, it becomes evident that efforts to eliminate stigma within healthcare must be prioritized. Advocacy for broader healthcare reforms, coupled with public education campaigns on substance use during pregnancy, can foster a community that supports rather than ostracizes. Such initiatives could not only improve the quality of care received by pregnant patients but also contribute to a cultural shift toward understanding and compassion.

Additionally, it is essential for researchers and policymakers to continuously monitor the evolving landscape of maternal healthcare. They should work collaboratively to develop and implement evidence-based guidelines that address stigma and promote transparent communication in clinical settings. By staying attuned to the voices of pregnant individuals and their experiences, the healthcare system could evolve to better meet their unique needs.

In conclusion, the important research conducted by Sharko, Ancker, Sharma, and colleagues brings to the forefront the pressing issue of stigma in healthcare settings, particularly regarding pregnant women and substance use. The findings serve as a clarion call for the medical community to nourish a culture of openness and understanding. By working together to diminish stigma, we can ensure that every pregnancy is supported with compassion and care, allowing mothers and their babies to thrive.


Subject of Research: Stigma affecting substance use disclosure in pregnant patients.

Article Title: Pregnant Patients are Less Likely to Disclose Substance USE if They Perceive Stigma in Their Clinic Notes.

Article References:

Sharko, M., Ancker, J.S., Sharma, M. et al. Pregnant Patients are Less Likely to Disclose Substance USE if They Perceive Stigma in Their Clinic Notes.
J GEN INTERN MED (2025). https://doi.org/10.1007/s11606-025-09869-w

Image Credits: AI Generated

DOI: 10.1007/s11606-025-09869-w

Keywords: pregnancy, substance use, stigma, healthcare, maternal health.

Tags: attitudes towards substance use in pregnancybarriers to healthcare for pregnant womeneffects of stigma on healthcare interventionsimpact of societal stigma on healthimportance of open communication in prenatal carematernal health challengesmental health and pregnancyprivacy concerns in prenatal carestigma in healthcare settingssubstance use disclosure during pregnancytransparency in maternal healthcareunderstanding pregnant women's substance use
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