Opioid use disorder (OUD) is a growing public health problem among pregnant and parenting people in the U.S. Between 1999 and 2014, the number of pregnant women with OUD increased by more than four times. This trend also coincides with a rise in pregnancy-associated maternal overdose mortality.
Researchers at Thomas Jefferson University, led by Meghan Gannon, PhD, MSPH, investigated how community-based supports, like doulas, can be integrated into health care for mothers who use opioids. Using a social network analysis, their study published in Midwifery examined the support systems and level of resiliency among 34 participants.
The results suggest that social support decreases among persons with OUD from the time of pregnancy until after childbirth, and that half of the participants of the study reported inadequate social support during that period. Participants with a higher resiliency score, however, were more likely to perceive doulas as a support during perinatal care.
“This decrease in social support from pregnancy through postpartum is an important finding to address, given the increased risk for relapse in the year after birth ,” says Dr. Gannon.
Once the baby is born, parents with OUD can experience anxiety over child welfare involvement and losing custody of their child, Dr. Gannon explains. Stigma around maternal substance use and being in recovery can also be a deterrent to seeking health care. “Therefore, increasing social support through non-traditional sources may help individuals with OUD have increased access to health care, creating an environment in which they feel safe.”
In the future, Dr. Gannon hopes to pioneer a peer recovery doula model – where those in recovery could be trained to provide doula support to new mothers with OUD. Dr. Gannon says that this approach could one day foster an authentic bond so that if mothers need extra support during the postpartum period, “they have someone they can trust and someone that’s been there themselves.”
By Deborah Balthazar
Journal
Midwifery