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Women's Health Education Program Scholars' Projects

Barriers to Care for Pregnant Women with Opioid Use Disorder: Stigma, Criminalization and Unmet Needs

WHEP scholar Camille Singh

WHEP Scholar Camille Singh
Drexel University College of Medicine, Class of 2021

Pregnant women with substance use disorders endure a unique, intense and pervasive type of stigma from multiple levels of society – from family and friends to government officials to health care professionals – a failure of moral judgment as well as a failure to adhere to societal expectations for their gender. Not only is the stigmatization itself a powerful deterrent to seeking help, but pregnant women also fear criminalization and loss of child custody if they seek treatment. Those who seek treatment are still stigmatized and judged, and do not receive the high-quality, comprehensive and tailored services that they need in order to achieve positive outcomes and successful recovery.

Pregnant women who are legally prescribed medicated-assisted treatment, such as buprenorphine or methadone, as part of their substance abuse treatment program are still reported to social services in the same way as a mother who is taking illicit opioids. This puts pregnant patients in a no-win situation, in which even if they do seek help and are getting appropriate treatment, they are still being punished; they are reported and judged, with the possibility of criminalization and loss of their child.

Women struggling with drug use during pregnancy already experience internal shame, guilt and confusion. Studies show that pregnancy is an impetus for many women to want to reduce their drug use, as these mothers fear harming their babies. Instead of perpetuating stigmatization of pregnant women who use drugs, efforts should be made to emphasize that a substance use disorder is a medical condition that limits a pregnant woman’s ability to stop using drugs. Measures need to be taken to reduce stigma and have healthier, nonjudgmental, more productive conversations about substance use during pregnancy, so that pregnant women do not feel forced to conceal their drug use but can instead ask for help.

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