A new study from Indiana University concludes that obstetricians and midwives are reluctant to confront patients in prenatal care about substance-abuse issues.

Researchers listened to audiotapes of conversations between pregnant patients and their obstetrical care providers and found that doctors and midwives were uncomfortable discussing alcohol and drug use with their patients, even when talking about the potential health risks of such behavior.

"Pregnant women are sensitive about being asked about substance abuse and some healthcare providers may feel that talking about these issues will compromise the provider-patient relationship," said Richard Frankel, Ph.D., a co-author of the study. "However, the evidence suggests that the benefits of a frank discussion about substance abuse far outweigh the costs to the relationship."

The researchers said that more education about drug and alcohol cessation programs will help better equip physicians when asking questions and advising patients who use or are at risk of abusing drugs or alcohol.

The study appeared in the September 2008 issue of the journal Patient Education and Counseling.