Post-Traumatic Stress in the Pregnancy-to-Postpartum Transition Among Birthing People With Opioid Use Disorder [ID 2683444

Abstract

INTRODUCTION: Postpartum people with opioid use disorder (OUD) face unique challenges; post-traumatic stress may trigger substance use recurrence and disrupt the parent–infant dyad. However, the effects of traumatic stress in the pregnancy-to-postpartum transition for birthing people with OUD are not well investigated. Our study characterizes post-traumatic stress after birth among people in OUD treatment during the fourth trimester. METHODS: This a priori secondary study uses longitudinal data investigating recovery among postpartum people with OUD receiving buprenorphine. Participants were enrolled during the third trimester and assessed within 2 weeks postpartum. Scores greater than 29 on the PTSD Checklist-Civilian at 2 weeks postpartum identified post-traumatic stress. Other measures included the following: maternal attachment, perceived control in childbirth, trauma history questionnaire, and child welfare involvement. VCU IRB #HM20017030 approved this study. RESULTS: Participants (N=19) were predominantly White (74%). Most (94.7%) endorsed a traumatic event history before delivery of this infant. Eight (42%) met criteria for post-traumatic stress postpartum and identified birth (n=2), infant medical issue (n=3), or unrelated event (n=3) elicited the post-traumatic stress response. Of these, approximately 25% experienced food insecurity and limited health care transportation. These participants reported high levels of maternal attachment (28.1 [SD=4.8]) and perceived control in childbirth (44.3 [SD=6.3]). Most participants reported postpartum child welfare involvement. CONCLUSION: Nearly half of our sample experienced post-traumatic stress symptoms after birth, and two-thirds attributed symptoms to a traumatic birth or infant medical issue. Qualitative investigations are warranted to better understand the patient perspective of these experiences and their unique intersections with OUD treatment and recovery to ultimately improve trauma-informed care strategies.