“Will My Baby Be OK?” A Qualitative Analysis of Pregnant Women’s Suboxone® Online Forum Posts

Abstract

Background: Intentional or accidental drug-overdose is a leading cause of mortality in U.S. women of child-bearing age. Opioid use during pregnancy is not only associated with maternal overdose, but with low birth weight at term and neonatal abstinence syndrome (NAS). Buprenorphine was approved as a medication for opioid use disorder (MOUD) in the United States in 2002 and is for many women, a preferred treatment option versus methadone. Buprenorphine is relatively safe during pregnancy and is associated with lower rates of NAS than methadone. Given the importance of MOUD during pregnancy, relatively little information exists regarding patients’ questions and concerns about buprenorphine treatment, including the psychological challenges they face. Aims: The purpose of the study was to describe the perinatal concerns of women with opioid use disorder who posted to an online suboxone forum. Methods: Qualitative descriptive design to analyze some 170 posts from mothers with OUD to an online Suboxone® support forum over the period 2016–2021. Results: The analysis of the interview data revealed 4 important themes: (a) Stigma resulting in self-deprecation, low self-esteem, and low self-efficacy; (b) stigma from family members and loved ones; (c) stigma from the medical profession; and (d) stigma from the community at-large (social stigma). Conclusions: There is compelling evidence to emphasize the importance of open communication and support between medical personnel and patients to ensure optimal outcomes for mother and baby.