A Window of Opportunity: Describing Participants Engaged in a Comprehensive Perinatal Care Model to Treat Substance Use Disorder During Pregnancy

Abstract
In 2019, 12% of pregnant persons were estimated to use psychoactive substances, the highest rate in US history. Substance use disorder (SUD) is a chronic, relapsing condition, and while pregnancy presents a unique opportunity for SUD intervention, research on pregnant and postpartum SUD patient experiences is vital for informing perinatal systems of care. The purpose of this presentation is to describe a sample from SUN, a comprehensive perinatal care program for pregnant persons with SUD in North Carolina.

Methods
We abstracted medical records (n=29), surveyed participants (n=29), and conducted two focus groups (n=7). Medical records provided participant demographics; medical, social, and legal history; care engagement; and birth outcomes. The focus groups and surveys captured patient experiences in SUN and barriers/facilitators to program engagement. Descriptive statistics (counts, percentages) were summarized for quantitative data. We used a thematic approach with inductive and deductive coding to analyze focus group and open-ended survey questions data.

Findings
Of the 29 participants, 96% were white, 100% reported opioid use at program entry, 66% were polysubstance users, and 21% were employed full or part time. Transportation and time spent at visits were reported as barriers to treatment; however, 83% said that SUN facilitated transportation for visits. Of singleton births, 87% were born at term (>37 weeks); All participants who entered the program in their first trimester had term births. Participants emphasized trust and unwavering support from providers as important to recovery, that parenting support was effective, and that pregnancy/parenting was the most motivating factor for pursuing recovery.