2023 Theses Master's

Retribution over Recovery: A Review of the Sociocultural Contexts and Legal Landscape Surrounding the Care of Pregnant People with Substance Use Disorders

Daaboul, Josephine

Substance use disorders (SUDs) are of great public health concern worldwide. Concurrently with the United States's epidemic of opioids and overdoses, substance use during pregnancy has increased. If left untreated, perinatal substance use can lead to negative health outcomes for both the pregnant person and infant. While there has been documented research to understand the signs and symptoms of neonatal abstinence syndrome (NAS) as a result of perinatal substance use, there has been less work focused on the dual focus of recovery care for the birthing person and prevention of NAS in the infant. Often, pregnant women and people are faced with the weight of moral scrutiny and judgment for their condition, the treatment of their bodies, and the lifestyle decisions they make. However, different conditions and social positions can impact the way someone experiences pregnancy-related healthcare. For people facing SUD during pregnancy, there is a convergence of societal pressures that can ultimately lead to worsened perinatal health outcomes. In addition, there are complex structural inequalities impacting both pregnancy and SUD care for people of color in particular. Using a sociocultural and political approach to understand the current contexts impacting perinatal SUD treatment, this paper aims to identify gaps in care, from clinical interactions to the criminal legal system. Knowing the short- and long-term consequences of unaddressed SUDs in pregnant women and people, it is vital to transition away from a myopic view of substance use during pregnancy and work towards providing whole-person care that extends pregnancy and beyond.