Engagement in perinatal outpatient services among women in recovery from opioid use disorders

Abstract

Background: Despite being highly motivated to recover, pregnant and postpartum women with opioid use disorders (OUD) are at high risk of relapse and death. While many services mitigate this risk, engagement in voluntary, outpatient services remains low. Our aim was to understand the experiences of and factors influencing outpatient service engagement during the perinatal period among women in recovery from OUD. Methods: We conducted semi-structured interviews about perinatal experiences engaging with outpatient services, with 20 women in recovery aged 22–46 years who had children between 6 months and 10 years old. Interviews were audio-recorded, transcribed, coded, and analyzed using conventional content analysis. Results: Women described a continuum of ‘collaborative engagement’ experiences, defined by the extent to which they perceived their providers or service organizations were invested in their journeys as a partners and advocates. The ability to achieve collaborative engagement depended upon two factors: (1) the woman’s transformational development as a mother and woman in recovery, and (2) her perception of the providers’ ability to meet her multifaceted needs. Conclusions: Women in recovery from OUD may experience deeper engagement in voluntary outpatient perinatal services when they perceive that their providers are invested and collaboratively engaging in their recovery and personal growth. Future research should test whether collaborative engagement improves service retention.

Abbreviations: IPV: Intimate Partner Violence; OUD: opioid use disorder

Keywords:

• Pregnant
• postpartum
• perinatal
• opioid use disorder
• service engagement
• qualitative

Acknowledgements

The authors would like to acknowledge Hannah Daglish and Briana Jurkowski for their contributions to the present study.

Disclosure statement

The authors Drs. Peacock-Chambers, Paterno and Friedmann, as well as Daniel Kiely and Tinamarie Fioroni have no declarations of interest relevant to this article to disclose. Dr. Byatt has served as a speaker for Sage Therapeutics, was a consultant for Sage Therapeutics and Ovia Health, and has received honoraria from Miller Medical Communications and WebMD/Medscape.

Additional information

Funding

This work was supported by the University of Massachusetts Amherst Center for Research on Families (CRF) and the Healthy Development Initiative (HDI); and National Center for Advancing Translational Sciences, National Institutes of Health, [1KL2TR002545]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.