This study describes the experience of pregnancy and childbirth from the perspective of women with opioid use disorder.
This qualitative study analyzed semi-structured interviews about the prenatal care and birth experience of nine women with opioid use disorder as a sub-analysis of a qualitative study of women with a history of sexual trauma. Transcripts were analyzed using inductive content analysis.
Analysis revealed unique interactions with the healthcare system specific to pregnant women with opioid use disorder. Participants identified pregnancy as a reason to enter and maintain recovery and an increased availability of resources when pregnant. Yet during labor and birth, concerns regarding pain control, child protective services involvement and provider stigma led to negative interactions with the healthcare system.
Pregnant woman with opioid use disorder face unique challenges when seeking care. The perspectives of women with a history of opioid use disorder can inform creation of a harm reduction, non-stigmatizing model of prenatal, labor and birth, and postpartum care.
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- Opioid use disorder documented at delivery hospitalization — united States, 1999–2014.Morb. Mortal. Rep. Surveill. Summ. 2018; 67https://doi.org/10.15585/mmwr.mm6731a1
- Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010.Lancet. 2013; 382: 1564-1574https://doi.org/10.1016/S0140-6736(13)61530-5
- Prenatal substance abuse: short-and long-term effects on the exposed fetus.Pediatrics. 2013; 131: e1009-e1024
- Prevalence of prescription and illicit drugs in pregnancy-associated non-natural deaths of Florida mothers, 1999–2005.J. Forensic Sci. 2013; 58: 1536-1541
- The relationship between sexual and physical abuse and substance abuse consequences.J. Subst. Abuse Treat. 2002; 22: 121-128
- Physical and sexual abuse among women and men with substance use disorders.Alcohol. Treat. Q. 2000; 18: 7-17https://doi.org/10.1300/J020v18n03_02
- Co-occurring psychiatric symptoms are associated with increased psychological, social and medical impairment in opioid dependent pregnant women.Am. J. Addict. 2010; 19: 416-421https://doi.org/10.1111/j.1521-0391.2010.00064.x
- The link between substance abuse and posttraumatic stress disorder in women.Am. J. Addict. 1997; 6: 273-283https://doi.org/10.1111/j.1521-0391.1997.tb00408.x
- Committee Opinion no. 711: opioid use and opioid use disorder in pregnancy.Obstet. Gynecol. 2017; 130: 488https://doi.org/10.1097/AOG.0000000000002229
- Patient-centered care to address barriers for pregnant women with opioid dependence.Obstet. Gynecol. Clin. North Am. 2017; 44: 95-107https://doi.org/10.1016/j.ogc.2016.11.004
- Caring for pregnant women with opioid use disorder in the USA: expanding and improving treatment.Curr. Obstet. Gynecol. Rep. 2016; 5: 257-263https://doi.org/10.1007/s13669-016-0168-9
- Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and Their Infants.Department of Health and Human Services, Rockville, MD2018
- Obstetric Care for Women with Opioid Use Disorder.Council on Patient Safety in Women’s Health Care, Washington, D.C2018 (. Accessed October 4, 2018)https://safehealthcareforeverywoman.org/patient-safety-bundles/obstetric-care-for-women-with-opioid-use-disorder/
- Opioid detoxification during pregnancy: a systematic review.Obstet. Gynecol. 2018; 131: 803-814https://doi.org/10.1097/AOG.0000000000002562
Kramlich D, Kronk R, Marcellus L, Colbert A, Jakub K Rural postpartum women with substance use disorders. Qual Health Res., 13.
- Complex calculations: how drug use during pregnancy becomes a barrier to prenatal care.Matern. Child Health J. 2011; 15: 333-341https://doi.org/10.1007/s10995-010-0594-7
- Pregnant women and substance use: fear, stigma, and barriers to care.Health Justice. 2015; 3https://doi.org/10.1186/s40352-015-0015-5
- Stigma as a barrier to substance abuse treatment among those with unmet need: an analysis of parenthood and marital xtatus.J. Fam. Issues. 2018; 39: 3-27https://doi.org/10.1177/0192513X15581659
- Pregnancy and childbirth after sexual trauma: patient perspectives and care preferences.Obstet. Gynecol. 2018; 132: 1461https://doi.org/10.1097/AOG.0000000000002956
- The qualitative content analysis process.J. Adv. Nurs. 2008; 62: 107-115https://doi.org/10.1111/j.1365-2648.2007.04569.x
- Reworking qualitative data.SAGE. 2004;
- Opioid use in pregnancy, neonatal abstinence syndrome, and childhood outcomes: executive summary of a joint workshop by the Eunice kennedy shriver national institute of child health and human development, american college of obstetricians and gynecologists, american academy of pediatrics, society for maternal-fetal medicine, centers for disease control and prevention, and the March of dimes foundation.Obstet. Gynecol. 2017; 130: 10https://doi.org/10.1097/AOG.0000000000002054
- Substance abuse treatment for pregnant women: a window of opportunity?.Addict. Behav. 1998; 23: 239-249https://doi.org/10.1016/S0306-4603(97)00029-4
- Reasons for substance use continuation and discontinuation during pregnancy: a qualitative study.Women Birth. 2018; (April)https://doi.org/10.1016/j.wombi.2018.04.001
- Integrated treatment programs for pregnant and parenting women with problematic substance use: service descriptions and client perceptions of care.J. Subst. Abuse Treat. 2018; 90: 9-18https://doi.org/10.1016/j.jsat.2018.04.008
- National Survey of Substance Abuse Treatment Services (N-SSATS).Department of Health and Human Services, Rockville, MD2015 (2015)
- Initiation and engagement with methadone treatment among pregnant and postpartum women.Womens Health Issues. 2017; 27: 646-651https://doi.org/10.1016/j.whi.2017.05.002
- Guttmacher Institute.2019 (. Accessed July 15, 2019)
- Perceptions of child protective services among pregnant or recently pregnant, opioid-using women in substance abuse treatment.Child Abuse Negl. 2018; 79: 125-135https://doi.org/10.1016/j.chiabu.2018.01.026
- Criminalizing substance use in pregnancy: misplaced priorities.Addiction. 2017; 112: 1123-1125https://doi.org/10.1111/add.13776
Published online: January 24, 2020
Accepted: January 8, 2020
Received in revised form: December 18, 2019
Received: September 29, 2019
© 2020 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.