The Lived Experiences of Pregnant and Parenting Women in Recovery Toward Medication Treatment for Opioid Use Disorder

Abstract

Background: Maternal misuse of prescription opioids and illicit drugs such as, heroin and non-pharmaceutical fentanyl analogs has increased in the last 2 decades and one in 5 women reported misuse of opioids. Medications for opioid use disorder (MOUD) are recommended for treating pregnant women with opioid use disorder (OUD). MOUD is effective in reducing cravings and negative outcomes, yet treatment is underutilized and varies in integration and intensity of resources across health systems. Exploring perceptions of MOUD delivery among pregnant/parenting women promises to uncover and address the underlying challenges to treatment, a perspective that may be different for providers and stakeholders. Therefore, our main purpose is to elicit patients’ experiences and perceptions of MOUD, associated access to treatment, and availability of supportive resources during pregnancy/postpartum to inform OUD treatment. Methods: Through a qualitative research approach we gathered data from individual interviews/focus group discussions for this pilot study. Pregnant and postpartum parenting women ( n = 17) responded to questions related to perceptions of MOUD, access to treatment, and availability of social and psychosocial resources. Data were collected, transcribed, and coded (by consensus) and emerging themes were analyzed using grounded theory methodology. Results: Emerging themes revealed positive uptake and perceptions of MOUD, continuing gaps in knowledge, negative impact of stigmatization, and limited access to programs and resources. Supportive relationships from family, peers, healthcare providers and child welfare staff, and co-located services were perceived as positive motivators to recovery. Conclusions: Through the unique lenses of women with lived experience, this study revealed several themes that can be transformative for women. Overall perceptions of MOUD were positive and likely to facilitate uptake and promote positive recovery outcomes. Bridging knowledge gaps will reduce anxieties, fears about neonatal opioid withdrawal syndrome and adverse maternal outcomes. Additionally, a deeper understanding of stigmatization and relationships can inform an integrated patient-centered approach to OUD treatment.

Healthcare experiences of pregnant and postnatal women and healthcare professionals when facing child protection in the perinatal period: A systematic review and Critical Interpretative Synthesis

“…We identified from the majority of included studies that both women and HCPs had one common objective: to do what is best for the (unborn) baby [ 15 , 54 , 55 , 60 , 62 – 64 , 66 – 68 , 70 , 73 , 76 – 78 , 80 – 82 , 85 – 87 , 89 ].…”

“…Several studies reported that women’s determination to ensure the baby’s wellbeing acted as a motivator to enter healthcare, even when they feared subsequent CP involvement [ 15 , 55 , 64 , 66 , 67 , 73 , 85 , 89 ].…”

“…Both women and HCPs reported they were faced with unrealistic expectations, that set them up to fail. Several studies explicitly mentioned how women found attending a vast number of appointments particularly challenging, especially when they were already feeling vulnerable or overwhelmed [ 73 , 76 , 77 , 93 ].…”

“…As women gained trust in their HCPs, they became more forthcoming with disclosing the issues they were facing, and more receptive of support void of judgement and punishment. [ 15 , 53 , 54 , 56 , 57 , 60 , 63 , 73 , 74 , 80 – 82 , 85 – 87 , 89 , 92 ].…”

“…The impact of a trusting relationship with HCPs and compassionate and respectful care was profound, and instilled or reinforced a belief in oneself as a ‘mother’, which many women had not experienced before [ 15 , 53 , 57 , 60 , 63 , 67 , 68 , 73 , 75 , 92 ].…”