“The elephant in the room;” a qualitative study of perinatal fears in opioid use disorder treatment in Southern Appalachia
Abstract Background Diagnoses of perinatal opioid use disorder (OUD) continue to rise in the United States. Patients and providers report obstacles to OUD treatment access. Difficulties include legal ambiguity related to Social Services notification requirements following a birth to people using opi...
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doaj-db50964551d54aa4b35e358c31e26cd12021-02-21T12:17:49ZengBMCBMC Pregnancy and Childbirth1471-23932021-02-0121111210.1186/s12884-021-03596-w“The elephant in the room;” a qualitative study of perinatal fears in opioid use disorder treatment in Southern AppalachiaCatherine Leiner0Tamara Cody1Nathan Mullins2Melinda Ramage3Bayla M. M. Ostrach4UNC School of MedicineMountain Area Health Education CenterMountain Area Health Education CenterMountain Area Health Education CenterDepartment of Research, UNC Health Sciences at MAHECAbstract Background Diagnoses of perinatal opioid use disorder (OUD) continue to rise in the United States. Patients and providers report obstacles to OUD treatment access. Difficulties include legal ambiguity related to Social Services notification requirements following a birth to people using opioids or in medication-assisted treatment for OUD. Methods Through semi-structured interviews, participant-observation, and a focus group conducted in a mostly rural, region of the Southern United States (where perinatal OUD is more prevalent), patients’ and providers’ perspectives about perinatal substance use treatment were initially sought for a larger study. The findings presented here are from a subset analysis of patients’ experiences and perspectives. Following ethics review and exemption determination, a total of 27 patient participants were opportunistically, convenience, and/or purposively sampled and recruited to participate in interviews and/or a focus group. Data were analyzed using modified Grounded Theory. Results When asked about overall experiences with and barriers to accessing perinatal substance use treatment, 11 of 27 participants reported concerns about Social Services involvement resulting from disclosure of their substance use during pregnancy. In the subset analysis, prevalent themes were Fears of Social Services Involvement, Preparation for Delivery, and Providers Addressing Fears. Conclusions Perinatal OUD patients may seek substance use treatment with existing fears of Social Services involvement. Patients appreciate providers’ efforts to prepare them for this potential reality. Providers should become aware of how their own hospital systems, counties, states, and countries interpret laws governing notification requirements. By becoming aware of patients’ fears, providers can be ready to discuss the implications of Social Services involvement, promote patient-centered decision-making, and increase trust.https://doi.org/10.1186/s12884-021-03596-wOpioid use disorderPerinatal substance use treatmentMedication assisted treatmentSocial servicesCAPTA laws |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Catherine Leiner Tamara Cody Nathan Mullins Melinda Ramage Bayla M. M. Ostrach |
spellingShingle |
Catherine Leiner Tamara Cody Nathan Mullins Melinda Ramage Bayla M. M. Ostrach “The elephant in the room;” a qualitative study of perinatal fears in opioid use disorder treatment in Southern Appalachia BMC Pregnancy and Childbirth Opioid use disorder Perinatal substance use treatment Medication assisted treatment Social services CAPTA laws |
author_facet |
Catherine Leiner Tamara Cody Nathan Mullins Melinda Ramage Bayla M. M. Ostrach |
author_sort |
Catherine Leiner |
title |
“The elephant in the room;” a qualitative study of perinatal fears in opioid use disorder treatment in Southern Appalachia |
title_short |
“The elephant in the room;” a qualitative study of perinatal fears in opioid use disorder treatment in Southern Appalachia |
title_full |
“The elephant in the room;” a qualitative study of perinatal fears in opioid use disorder treatment in Southern Appalachia |
title_fullStr |
“The elephant in the room;” a qualitative study of perinatal fears in opioid use disorder treatment in Southern Appalachia |
title_full_unstemmed |
“The elephant in the room;” a qualitative study of perinatal fears in opioid use disorder treatment in Southern Appalachia |
title_sort |
“the elephant in the room;” a qualitative study of perinatal fears in opioid use disorder treatment in southern appalachia |
publisher |
BMC |
series |
BMC Pregnancy and Childbirth |
issn |
1471-2393 |
publishDate |
2021-02-01 |
description |
Abstract Background Diagnoses of perinatal opioid use disorder (OUD) continue to rise in the United States. Patients and providers report obstacles to OUD treatment access. Difficulties include legal ambiguity related to Social Services notification requirements following a birth to people using opioids or in medication-assisted treatment for OUD. Methods Through semi-structured interviews, participant-observation, and a focus group conducted in a mostly rural, region of the Southern United States (where perinatal OUD is more prevalent), patients’ and providers’ perspectives about perinatal substance use treatment were initially sought for a larger study. The findings presented here are from a subset analysis of patients’ experiences and perspectives. Following ethics review and exemption determination, a total of 27 patient participants were opportunistically, convenience, and/or purposively sampled and recruited to participate in interviews and/or a focus group. Data were analyzed using modified Grounded Theory. Results When asked about overall experiences with and barriers to accessing perinatal substance use treatment, 11 of 27 participants reported concerns about Social Services involvement resulting from disclosure of their substance use during pregnancy. In the subset analysis, prevalent themes were Fears of Social Services Involvement, Preparation for Delivery, and Providers Addressing Fears. Conclusions Perinatal OUD patients may seek substance use treatment with existing fears of Social Services involvement. Patients appreciate providers’ efforts to prepare them for this potential reality. Providers should become aware of how their own hospital systems, counties, states, and countries interpret laws governing notification requirements. By becoming aware of patients’ fears, providers can be ready to discuss the implications of Social Services involvement, promote patient-centered decision-making, and increase trust. |
topic |
Opioid use disorder Perinatal substance use treatment Medication assisted treatment Social services CAPTA laws |
url |
https://doi.org/10.1186/s12884-021-03596-w |
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