A study led by researchers at the University of Missouri and the University of Iowa shows that mothers who use opioids in the perinatal stage experience stigma that can impact their healthcare - and the healthcare received by their infants.
Jamie Morton, a postdoctoral research fellow at the University of Iowa, led the study while she was a PhD student at MU. Morton was a bedside nurse and nursing educator before earning her PhD at Sinclair School of Nursing, and said that her experiences as a nurse led her to pursue her doctorate and look closer at the opioid epidemic.
“Over time, I noted that there was, it just seemed like an increase in… the number of infants that I was told were not acceptable to assign nursing students to because they were going through withdrawal,” Morton said.
The study, which was published in The Western Journal of Nursing Research in late June of 2023, examined qualitative reports and found that opioid-dependent mothers can experience stigma from their healthcare providers.
“We have this perception of threat and harm associated with opioid misuse and with drug use. But even more than that, when we look specifically in the population of women, especially women of childbearing age and women who are having babies, there is this perception that they have morally deviated from what people consider the normal cultural expectations are,” Morton said.
Morton said the reports showed that mothers would often react to stigmatizing behaviors by withdrawing themselves from being active participants in their healthcare. The research team also found something surprising - although the study was originally only looking at mothers, researchers found that the healthcare of their infants was also impacted by stigma.
“A lot of times these women found that … they lost their voice. And they lost their ability to be included in any type of decisions regarding care for themselves or for their infant,” Morton said.
Reports that were analyzed in the study showed that some moms felt that their children were treated differently from other infants who were not withdrawing from opioids. Researchers also found that, in an attempt to protect their child from the same stigma that they experienced, the moms would then sometimes decline to take their infants to follow ups or actively participate in their healthcare decisions.
Morton added that this could then lead to further stigma from members of their healthcare team.
“The perception is that these women are… being bad mothers, they're not taking care of their child,” Morton said. “When what the mothers are perceiving they're doing is that they're protecting them. ”
She said this highlights a need for training that will help providers give compassionate, understanding care that encourages moms to actively seek healthcare for themselves and their babies. Some of the solutions that Morton and the researchers came up with were things like education around what stigma is, how it can present itself and how individuals can self-reflect and recognize when they are perpetuating it.
“It just takes one time to put these people in kind of a tailspin and get him trapped in this cycle,” Morton said. “And sometimes I don't even think that we are aware that we are even perpetuating this, to be very honest.”
