Perspectives of the Obstetric Care Environment for Pregnant Individuals Who Have an Opioid Use Disorder

Objective: To assess the specific barriers and facilitators for pregnant individuals who have an opioid use disorder (OUD) receiving perinatal care. Methods: We conducted key informant interviews with patients who received care from obstetric clinicians who had been trained to provide medication for...

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Main Authors: Samantha Girasulo, Caro Maltz, Maggie Weichert, Joy S. Kaufman, Amanda Mele, Karen Hunkele, Kimberly A. Yonkers, Nancy Byatt, Ariadna Forray
Format: Article
Language:English
Published: Mary Ann Liebert 2025-01-01
Series:Women's Health Reports
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Online Access:https://www.liebertpub.com/doi/10.1089/whr.2024.0142
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author Samantha Girasulo
Caro Maltz
Maggie Weichert
Joy S. Kaufman
Amanda Mele
Karen Hunkele
Kimberly A. Yonkers
Nancy Byatt
Ariadna Forray
author_facet Samantha Girasulo
Caro Maltz
Maggie Weichert
Joy S. Kaufman
Amanda Mele
Karen Hunkele
Kimberly A. Yonkers
Nancy Byatt
Ariadna Forray
author_sort Samantha Girasulo
collection DOAJ
description Objective: To assess the specific barriers and facilitators for pregnant individuals who have an opioid use disorder (OUD) receiving perinatal care. Methods: We conducted key informant interviews with patients who received care from obstetric clinicians who had been trained to provide medication for opioid use disorder (n = 16). We asked patients about the care they received for their OUD, the quality of communication with their perinatal care team, and any recommendations for improving OUD care. Two staff independently coded transcripts, and we used content analysis to identify themes. Results: Our analysis resulted in three main facilitators that support participants receiving care from their obstetric clinician: (1) positive relationship with supportive and nonjudgmental clinician; (2) access to medication for opioid use disorder (MOUD); and (3) access to therapeutic and peer supports. Patients noted that nonjudgmental clinicians provided a care environment where they felt safe, did not experience stigma, and felt they could be active participants in their care. Patients also expressed that access to MOUD and clinical and supportive services were beneficial components of perinatal care. The main barriers identified included lack of access to transportation, long wait times for treatment programs, and difficulty accessing MOUD. Conclusions: The results of this study suggest that increased obstetric provider education about OUDs and providing trauma-informed care for pregnant individuals who have an OUD may help reduce barriers to accessing care and increase satisfaction with care for this population. Furthermore, the present study suggests obstetricians provide in-house access to MOUD, if possible, or assist patients with referrals to care, as these may reduce the structural barriers patients face.
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spelling doaj-art-2a9ed936ca58403dbc60e11fb0509bdd2025-08-20T03:49:42ZengMary Ann LiebertWomen's Health Reports2688-48442025-01-016115516010.1089/whr.2024.0142Perspectives of the Obstetric Care Environment for Pregnant Individuals Who Have an Opioid Use DisorderSamantha Girasulo0Caro Maltz1Maggie Weichert2Joy S. Kaufman3Amanda Mele4Karen Hunkele5Kimberly A. Yonkers6Nancy Byatt7Ariadna Forray8Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA.Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.Objective: To assess the specific barriers and facilitators for pregnant individuals who have an opioid use disorder (OUD) receiving perinatal care. Methods: We conducted key informant interviews with patients who received care from obstetric clinicians who had been trained to provide medication for opioid use disorder (n = 16). We asked patients about the care they received for their OUD, the quality of communication with their perinatal care team, and any recommendations for improving OUD care. Two staff independently coded transcripts, and we used content analysis to identify themes. Results: Our analysis resulted in three main facilitators that support participants receiving care from their obstetric clinician: (1) positive relationship with supportive and nonjudgmental clinician; (2) access to medication for opioid use disorder (MOUD); and (3) access to therapeutic and peer supports. Patients noted that nonjudgmental clinicians provided a care environment where they felt safe, did not experience stigma, and felt they could be active participants in their care. Patients also expressed that access to MOUD and clinical and supportive services were beneficial components of perinatal care. The main barriers identified included lack of access to transportation, long wait times for treatment programs, and difficulty accessing MOUD. Conclusions: The results of this study suggest that increased obstetric provider education about OUDs and providing trauma-informed care for pregnant individuals who have an OUD may help reduce barriers to accessing care and increase satisfaction with care for this population. Furthermore, the present study suggests obstetricians provide in-house access to MOUD, if possible, or assist patients with referrals to care, as these may reduce the structural barriers patients face.https://www.liebertpub.com/doi/10.1089/whr.2024.0142opioid use disorderpatient perspectivesperinatal obstetric carequalitative study
spellingShingle Samantha Girasulo
Caro Maltz
Maggie Weichert
Joy S. Kaufman
Amanda Mele
Karen Hunkele
Kimberly A. Yonkers
Nancy Byatt
Ariadna Forray
Perspectives of the Obstetric Care Environment for Pregnant Individuals Who Have an Opioid Use Disorder
Women's Health Reports
opioid use disorder
patient perspectives
perinatal obstetric care
qualitative study
title Perspectives of the Obstetric Care Environment for Pregnant Individuals Who Have an Opioid Use Disorder
title_full Perspectives of the Obstetric Care Environment for Pregnant Individuals Who Have an Opioid Use Disorder
title_fullStr Perspectives of the Obstetric Care Environment for Pregnant Individuals Who Have an Opioid Use Disorder
title_full_unstemmed Perspectives of the Obstetric Care Environment for Pregnant Individuals Who Have an Opioid Use Disorder
title_short Perspectives of the Obstetric Care Environment for Pregnant Individuals Who Have an Opioid Use Disorder
title_sort perspectives of the obstetric care environment for pregnant individuals who have an opioid use disorder
topic opioid use disorder
patient perspectives
perinatal obstetric care
qualitative study
url https://www.liebertpub.com/doi/10.1089/whr.2024.0142
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