The purpose of this review is to describe how pregnant and postpartum women with substance use disorders (SUDs) experience health care encounters in prenatal care, labor and delivery, postpartum, and nursery/neonatal intensive care unit (NICU) settings. Findings from 23 qualitative studies on the topic were synthesized using a metasummary approach. The majority of the studies revealed that pregnant and postpartum women with SUDs tend to experience their health care encounters as conflictual, although some studies revealed that some women experience their health care encounters as supportive. The results of metasummary included a taxonomy of health care encounters. Five types of adverse encounters were identified: judgmental, disparaging, scrutinizing, disempowering, and deficient-care. Three types of beneficial encounters were identified: recovery-based, accepting, and effective-care. The findings suggest the importance of stigma awareness, therapeutic patient-provider communication, patient activation, and integrated care.

Objective: This study aimed to identify the influence of the four constructs of social support on positive pregnancy experiences in CenteringPregnancy, a group prenatal care (GPNC) model. Methods: Using a qualitative descriptive design, semi-structured interviews were conducted with 11 women who had participated in at least 6 of 10 GPNC sessions at a family practice medicine residency. Participants were asked to describe their experiences in GPNC. Results: Using a standard content analysis, four constructs of social support (emotional, informational, instrumental, and appraisal) were identified through three major themes: (1) informational support, offered by peers in GPNC settings, promotes learning and prepares women for motherhood; (2) emotional and appraisal support, offered by peers in GPNC, improves emotional well-being and helps women build lasting, supportive connections with peers, and (3) emotional, informational, instrumental, and appraisal support work in tandem to create positive relationships between women and health care providers. Conclusion: Social support provided a means to a positive prenatal health care experience that facilitated the attainment of new knowledge and the formation of positive relationships with health care providers and peers. The findings of this study can provide health care providers with a framework to examine and enhance their practice and care of women in the perinatal period.

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Trusting relationships between pregnant and postpartum women with substance use disorders (SUDs) and maternity nurses can improve health outcomes for women and their infants. This study was conducted to identify factors associated with the formation of trust in these nurse–patient relationships. Using a qualitative description approach, semi-structured interviews were conducted with 10 women who used substances during pregnancy and 15 maternity nurses. The narratives were analyzed with standard content analytic techniques. Findings revealed that six characteristics of nurses and five characteristics of women fostered or hindered the formation of trusting relationships. The characteristics of the maternity nurses were (a) interpersonal connections, (b) demeanor toward women, (c) ways of providing care, (d) approaches to providing information, (e) attitudes toward substance use, and (f) addiction expertise. The characteristics of the women were (a) engagement with nurses, (b) demeanor toward nurses, (c) attitudes toward care, (d) investment in recovery, and (e) ways of interacting with infant. The characteristics provide a framework by which maternity nurses can examine their attitudes and behaviors toward women with SUDs and inform the development of strategies to enhance their practice with this population.