Expanding on Recovery Capital evidence to support pregnant and postpartum peoples’ recovery

Issue/problem
Recovery Capital (RC) offers an ecological understanding of the internal and external resources a person has at their disposal to begin and sustain recovery from substance use disorders (SUD). Pregnant and postpartum people have been underrepresented in RC research, however, leading to knowledge gaps surrounding the specific resources necessary to improve their recovery outcomes. This, in turn, limits the ability of public health practitioners to effectively respond in these unique circumstances, to enhance both their wellbeing and that of their offspring.

Description of the problem
Sparse international literature suggests that to predict recovery outcomes for pregnant and postpartum populations, the specific dynamics and needs of the parent-infant dyad, and the resources directly affecting their wellbeing, must be considered in interaction. To inform emerging evidence expanding RC theory to pregnant and postpartum populations, we contribute findings from a US community-based perinatal SUD treatment model evaluation.

Results
Qualitative and quantitative evaluation findings assessing parental health, birth outcomes, and program experiences of 29 participants and 9 staff across two program years revealed that responsive prenatal care and behavioral intervention, skills-based parenting supports, and preservation of the family unit by avoiding separation, were effective in helping people remain in recovery throughout their pregnancies. Participants further expressed will, desire, and ability to plan for long term recovery.

Lessons
Ecological supports for pregnant and postpartum persons recovering from SUD are effective at meeting health and recovery goals for participants and supporting positive birth outcomes. Considerations for adapting the RC model to meet the needs of pregnant populations, and implications for adapting the model to public health practice, are discussed.

Key messages
• Ecological supports for the parent-infant dyad, which are not yet described in the Recovery Capital model, are effective at meeting recovery goals for pregnant and postpartum people with SUD.

• Evidence supports consideration for adapting the RC model to meet the needs of pregnant populations and has strong implications for adapting the model to public health practice.