Navigating opioid use disorder treatment for pregnant and parenting people: composite narratives for policy action

Opioid use during pregnancy and the postpartum period is increasing in the United States, yet many pregnant and parenting people face serious barriers to accessing effective treatment and supportive services. These barriers arise from fragmented systems such as healthcare, health insurance, child welfare, childcare, and the criminal justice system. This study uses in-depth interviews with healthcare providers, treatment leaders, local government officials, and pregnant and parenting people in a mid-Atlantic state to explore access to medication for opioid use disorder (MOUD), key treatment barriers, and the role of policy in shaping care. Findings highlight how stigma, social and structural determinants of health, and misaligned policies across multiple systems limit access to care. The study underscores the need for policy approaches that recognize the unique needs of pregnant and postpartum people and better support recovery for individuals and families.