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Barriers to Care for Pregnant and Post-Partum Women Experiencing Co-Occurring Intimate Partner Violence and Opioid Use Disorder

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Abstract

Purpose

Thecurrent manuscript explores barriers to care for pregnant and post-partum women experiencing co-occurring intimate partner violence and opioid use disorder through the lens of providers who work with this unique population.

Methods

We conducted a qualitative study consisting of 49 semi-structured, open-ended interviews with service providers working across contexts (e.g., IPV, prenatal care, substance use, addiction medicine, law enforcement, criminal justice, welfare services, etc.).

Results

Participants reported three main types of barriers which can impact outcomes and reduce care for pregnant and post-partum women with co-occurring IPV and OUD (Co-IPV/OUD). 1) Barriers that make it difficult for pregnant or post-partum women to seek, receive, and successfully engage in care for both IPV and OUD. Barriers that providers encounter in trying to care for and/or treat pregnant and post-partum women with Co-IPV/OUD. Lastly, barriers which present a challenge to providing comprehensive, coordinated care for pregnant or post-partum women with Co-IPV/OUD.

Conclusion

We conclude that finding ways to improve coordinated or integrated care for IPV and OUD is vital to outcomes for this population, and initiatives which support providers’ ability to work across different service contexts are needed.

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Notes

  1. For ease of presentation and logistical flow of the manuscript, the results of the thematic analysis related to barriers to care are presented here as unique themes. However, these challenges are often interrelated and more likely represent a set of difficulties that holistically affect providers’ ability to care for pregnant and post-partum women with Co-IPV/OUD on multiple levels. Additionally, as our focus was on the barriers to care specifically for pregnant or post-partum women experiencing IPV and OUD, we have only included those barriers which are associated with the intersection of these experiences (IPV and OUD, and/or IPV or OUD and pregnancy/post-partum). Thus, our list of barriers presented here is not exhaustive. Finally, while we asked providers specifically about OUD, some providers framed their responses within the context of substance abuse more generally – a point we will address in our discussion.

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Authors and Affiliations

  1. Penn State New Kensington, 3550 Seventh St. Road, New Kensington, PA, 15068, USA

    Penelope K. Morrison

  2. Chatham University, Pittsburgh, PA, USA

    Emily Yourish

  3. Department of Obstetrics, Gynecology & Reproductive Sciences and General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    Judy C. Chang & Elizabeth Krans

  4. Making Cents International, Washington, DC, USA

    Chelsea Pallatino-Trevelline

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  1. Penelope K. Morrison
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  2. Emily Yourish
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  3. Judy C. Chang
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Correspondence to Penelope K. Morrison.

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Morrison, P.K., Yourish, E., Chang, J.C. et al. Barriers to Care for Pregnant and Post-Partum Women Experiencing Co-Occurring Intimate Partner Violence and Opioid Use Disorder. J Fam Viol 38, 1625–1637 (2023). https://doi.org/10.1007/s10896-022-00466-7

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