City Research Online

Abstract

Objectives. This qualitative study investigates the lived experience of women who have used illicit opioids such as heroin who become pregnant, and their complex journey of peri-natal and post-natal healthcare. The study seeks to identify findings from the women’s lived experiences and to inform current practice, interventions and services aimed at supporting women with opioid use disorder (OUD) who become pregnant.

Design. The study is a qualitative cross-sectional design based on interviews with a single cohort of five women, aged between eighteen and forty-five who were registered in the NHS and had been diagnosed with opioid use disorder (OUD). The cross-sectional design allows the lived experience to be investigated at different stages of a perinatal to post-natal healthcare journey, into motherhood. Parental custody was not required to participate.

Methods. The study received NHS Ethics approval in April 2023. The women were recruited from NHS Substance Misuse Services. Each participant was interviewed once and was between twenty-four weeks pregnant and eight years post birth. The participants were engaged in opioid substitute therapy (OST), at the time of the interview, or had recently ceased OST. Semi-structured interviews were conducted with five women and were transcribed verbatim by the author. Data were analysed using Reflexive Thematic Analysis (RTA).

Results. The findings include four themes: The Promise of Motherhood illustrates the surprise and joy on discovering pregnancy and engagement/re-engagement with substance misuse services. Managing Mother, Me as Risk describes the difficulties the women experience with multi-agency health care in processes which are not fully understood and are anxiety provoking. What Helps portrays actions which the women felt were supportive and helpful. The Development of Self conveys changes in psychological processes indicating that the women’s reflexivity and insight develops over time, and that their recovery is non-linear.

Conclusions. The findings suggest that pregnancy and the promise of motherhood represent a pathway of potential change and recovery for the women, yet the women’s feelings of stigma and experiences of being objectified as a risk in multi-agency health care serve to undermine the women’s nascent recovery and sense of self. Clinical implications include repositioning and adaptations in multi-agency health care, providing the women with more information about multi-agency healthcare, a greater role for NHS Substance Misuse Services to which the women display high levels of attachment, improved availability of therapeutic support at key phases, stigma training incorporating motivational interviewing and the use of mid-wives trained in substance misuse.

Publication Type:	Thesis (Doctoral)
Subjects:	B Philosophy. Psychology. Religion > BF Psychology H Social Sciences > HQ The family. Marriage. Woman R Medicine R Medicine > RG Gynecology and obstetrics R Medicine > RT Nursing
Departments:	School of Health & Medical Sciences > Psychology School of Health & Medical Sciences > School of Health & Medical Sciences Doctoral Theses Doctoral Theses

Export

Downloads