DNP Scholarly Projects

Abstract

The rise in rates of opioid addiction among women of childbearing age, alongside the consistent rates of unintended pregnancy, has changed the landscape for the public health risks and outcomes of unintended pregnancies in the United States. Concurrently, uptake of long-acting reversible contraception (LARC) remains low among all women, particularly those with substance use disorder. This project explores the perceived barriers to LARC among women enrolled in medication-assisted treatment (MAT) for opioid addiction. A mixed methods, cross-sectional survey design was used to capture how women in MAT access care, their reproductive planning and intention, contraceptive knowledge and behavior, and their perceived barriers to LARC. Of the 50 women interviewed, 84% experienced at least one unintended pregnancy in her lifetime. Although approximately 75% of women indicated awareness of both the IUD and implant, only 6% reported the use of either of these devices. A total of 21 themes related to the likelihood of LARC uptake were identified among free-text responses. Of these, the greatest barriers to the uptake of LARC were women’s expressed fears of complication related to LARC use, and the myths propagated by the relationship influences of family, friends, and acquaintances. The design and implementation of grassroots LARC marketing could replace or mute the misinformation and cautionary advice that seems to be cultivated along the social grapevine. Frequent, often daily, contact with the healthcare system for women within medication-assisted treatment facilities provides an excellent avenue for improved access to appropriate LARC information alongside the provision of appropriate resources for reproductive health. Integrating these services aligns with current recommendations for comprehensive care of women seeking treatment for SUD and can serve to support each woman’s commitment to sustained recovery by promoting both contraceptive choice and reproductive autonomy.

Date

3-6-2018

First Advisor

Morse, Elizabeth

Scholarly Project Team Member

Wofford, Linda G.

Scholarly Project Team Member

Busby, Steven

Department

Nursing, School of

College

Health Sciences & Nursing, Gordon E. Inman College of

Document Type

Scholarly Project

Degree

Doctorate of Nursing Practice (DNP)

Degree Level

Doctoral

Degree Grantor

Belmont University

Keywords

Opioid abuse; Unwanted pregnancy; Contraceptives; Women drug addicts

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