Abstract
Introduction
In 2016, 2.1 million people in the United States were estimated to have an opioid
use disorder. Although the disorder can be safely and effectively treated with prescription
methadone, treatment is potentially long term and may span women's peak childbearing
ages. Little is known about women's reproductive health needs while on methadone.
Methods
We interviewed 22 sexually active, nonpregnant women ages 21–39 years at two Los Angeles
methadone clinics in 2016. The interviews were transcribed and coded by four researchers
using thematic and open coding techniques.
Results
One-half of the women were nulliparous and 17 were in stable, monogamous relationships
with men. Women reported a range of feelings and perceptions about pregnancy, but
nearly all wanted to delay pregnancy until discontinuing methadone. However, many
women indicated limited interest in preventing pregnancy because of the relative stability
of their relationships, fear of infertility, and low perceived risk of pregnancy.
These factors influenced contraceptive use.
Discussion
Women described mixed feelings about pregnancy and many ultimately felt that an unplanned
pregnancy would be acceptable in the context of their relationships and uncertain
fertility. These findings provide context for previous quantitative findings that
women in methadone treatment have higher rates of unintended pregnancy and lower rates
of contraceptive use than the general population.
Conclusions
Accurate information about pregnancy in the context of methadone treatment may help
women to make proactive family planning decisions. Health care providers should discuss
the guidelines for pregnancy on methadone and offer a range of options to help women
achieve their reproductive goals.
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Biography
Marta Bornstein, MPH, is a PhD student in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Her research focuses on sexual and reproductive health, both in the United States and internationally.
Biography
Jessica D. Gipson, MPH, PhD, is an Associate Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Her research focuses on sexual and reproductive health of marginalized communities and populations.
Biography
Roselle Bleck, BA, is a medical student, UCLA David Geffen School of Medicine, and is pursuing an MPH in Health Policy, Columbia University's Mailman School of Public Health. She will devote her career to women's health, focusing on access to reproductive health care.
Biography
Aparna Sridhar, MD, MPH, is an Assistant Professor in the Department of Obstetrics and Gynecology at the UCLA David Geffen School of Medicine. Her research interests are focused on contraception, family planning, and the development of patient education tools.
Biography
Agatha Berger, MD, MPH, is a faculty member of the Department of Obstetrics & Gynecology, Christiana Care Health System, Newark, Delaware. Her research interests include the impacts of substance use disorders on women's reproductive health and lives and to reproductive health care.
Article info
Publication history
Published online: November 13, 2018
Accepted:
October 10,
2018
Received in revised form:
September 18,
2018
Received:
March 24,
2018
Footnotes
The views and opinions expressed are those of the authors and do not necessarily represent the views and opinions of funders.
This was funded via a grant from the Society of Family Planning Research Fund and Grants and support from NICHD Center grant P2C-HD041022 and Training grant T32-HD007545.
Identification
Copyright
© 2018 Jacobs Institute of Women's Health. Published by Elsevier Inc.
