Experiences of opioid-dependent women in their prenatal and postpartum care: Implications for social workers in health care

Abstract

The prevalence of prescription opioid abuse has increased nationally in the last decade with increased incidence rates reported among pregnant women. This was a qualitative study designed to understand the role of pregnant women with an opioid use disorder participating in medical decision making regarding their prenatal care while addressing their addiction. Group interviews were conducted with postpartum women who self-identified as opioid dependent during their pregnancy, and the data were analyzed using Interpretative Phenomenological Analysis. Social workers in the health care setting are an integral part of the interdisciplinary team in caring for pregnant and postpartum opioid-dependent women. Social workers are ideal in creating stigma reduction strategies, peer and professional supports, and comprehensive coordinated care. A social justice-based practice may be a framework to utilize when caring for this unique population.

In their own words: a qualitative study of factors promoting resilience and recovery among postpartum women with opioid use disorders

“…Pregnant women with substance use disorders are often perceived as criminals rather than individuals with a serious health condition [13], resulting in an uncertain and potentially hostile environment of care [14,15]. For many pregnant women, substance use treatment is difficult to obtain due to lack of programs willing to treat pregnant women, cost, lack of medical coverage, fear of legal consequences, and threat of child protection involvement for women who have children [16,17]. These factors intensify the stigma associated with prenatal substance use [16,[18][19][20][21] and are reinforced by social determinants, further limiting access to care [19,22,23].…”

Health Care Encounters of Pregnant and Postpartum Women with Substance Use Disorders

“…Pregnant women and postpartum women with SUDs experience stigma through judgmental attitudes expressed by health care providers. The women report that because they use substances providers undermine their decision-making, refer to them with negative labels (e.g., "methadone mom") and provide differential treatment for them, thereby the impairing formation of trust (Demirci et al, 2015;Howard, 2015;Howard, 2016;Jessup et al, 2003;Leppo, 2012). Perceived stigma has been associated with increased substance use and dissatisfaction with pregnancy (Best et al, 2014) and decreased utilization of prenatal health care (Gilchrist et al, 2012;Hall & Teijlingen, 2006).…”

“…Demirci et al, (2015) In this analysis, we describe the experiences and perceptions impacting breastfeeding decisions among pregnant and postpartum women taking methadone. (Cleveland et al, 2016;Cleveland & Bonugli, 2014;Cleveland & Gill, 2013;Howard, 2015;Howard, 2016;Jarlenski et al, 2016;Kramlich et al, 2018;McGlothen et al, 2018;Roberts & Nuru-Jeter, 2010;Roberts & Pies, 2011;Salmon et al, 2000;Scott et al, 2017;Stone 2015;Suarez et al, 2018) .53…”

“…Pregnant and postpartum women with SUDs feel providers do not provide optimal care, spend enough time with them, or act in a manner that is compassionate, trustworthy, and supportive. (Cleveland & Bonugli 2014;Cleveland & Gill, 2013;Howard, 2016;Kramlich et al, 2018;Kuo et al, 2013;Mattocks et al, 2017;Roberts & Nuru-Jeter, 2010;Roberts & Pies, 2011;Salmon et al, 2000;Scott et al, 2017;Stone, 2015) .43…”

Addiction Social Work Fellowship Program in Canada

“…For instance, a systematic review of collaborative chronic care models found that patients with mental health conditions who had received collaboratively-administered interventions were less depressed, had better physical quality of life and social role function than those who did not (Woltmann ALL AUTHORS ., 2012). Within such interdisciplinary care teams research has shown that social workers play a critical role in addressing the psychosocial needs of patients (Howard, 2016;Miller et al, 2007).…”