Treatment for substance use disorders in pregnant women: Motivators and barriers

Drug Alcohol Depend. 2019 Dec 1:205:107652. doi: 10.1016/j.drugalcdep.2019.107652. Epub 2019 Oct 22.


Background: Pregnancy is a unique opportunity to provide broad and necessary medical care for women- including treatment for Substance Use Disorders (SUD). The standard of care for SUD in pregnant women is treatment at a comprehensive care facility. There is little existing qualitative research exploring what brings pregnant women with SUD to treatment and what barriers to treatment exist for this population. This study explored women's self-reported reasons for pursuing treatment or hesitating to do so.

Methods: This qualitative study used interviews to explore common factors that motivate pregnant women with SUD to seek comprehensive care during pregnancy and common hesitations/ barriers to treatment. The study population included 20 women in treatment at a comprehensive care facility for pregnant and parenting women at Johns Hopkins. Participants volunteered to do interviews which were recorded and transcribed for analysis.

Results: Interviews revealed several major themes in motivators to seek treatment: readiness to stop using, concern for the baby's health, concern about custody of the baby or other children, wanting to escape violent environments or homelessness, and seeking structure. Barriers to treatment included fear of loss of custody, not wanting to be away from children/partner, concern about stigma or privacy, and lack of childcare and transportation.

Conclusions: This study revealed common motivators to seek treatment and barriers to treatment for pregnant women with SUD. These themes may help direct future studies and guide efforts to increase access to crucial care in this vulnerable population.

Keywords: Addiction; Medication; Medication treatment; Neonatal abstinence syndrome; Neonatal opioid withdrawal syndrome; Pregnancy; Stigma; Substance use disorder; Treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Humans
  • Motivation*
  • Pregnancy
  • Pregnancy Complications / psychology*
  • Pregnancy Complications / therapy
  • Pregnant Women / psychology*
  • Prenatal Care / methods
  • Prenatal Care / psychology*
  • Qualitative Research
  • Substance-Related Disorders / psychology*
  • Substance-Related Disorders / therapy