DNP Scholarly Projects


The prevalence of unintended pregnancy among women receiving medication assisted treatment (MAT) for opioid use disorder (OUD) exceeds 80%. While much of the existing literature has focused on the consequences of substance use in pregnancy, few have focused on the prevention of unintended pregnancy. This study explored barriers and facilitating factors impacting contraception use among women, ages 18-45, receiving MAT for OUD in Middle Tennessee. A cross-sectional survey design was used to describe the women’s sociodemographic and health characteristics; report their knowledge, attitudes, and behaviors; and to assess if these variables are associated with current use of contraception. Among survey respondents (N=262; response rate of 98%), most women were publicly insured (92%), sexually active in the past year (88.2%), pregnant at least once in their lifetime (97%), and most had experienced at least one unintended pregnancy (83.6%). Although 60.7% agreed it was important to avoid pregnancy, all contraception groups had low levels of contraception knowledge. Consistent voluntary use of reliable contraception, like long-acting reversible contraception (LARC), can reduce the risk of unintended pregnancy among women with OUD. Improvement strategies are warranted to ensure women enrolled in MAT for OUD have access to reliable contraception methods and noncoercive contraceptive counseling to curb the rising rates of unintended pregnancy and reduce rates of neonatal abstinence syndrome (NAS). Integrating reproductive health services into MAT programs may support the woman’s commitment to sustained recovery by promoting continuity of care and reproductive autonomy while being cognizant of historical trauma and current disparities. Keywords: contraception, opioid use disorder, substance use disorder, and addiction.



First Advisor

Dr. Linda Wofford

Scholarly Project Team Member

Dr. David Philippi

Scholarly Project Team Member

Dr. David Wyant

Scholarly Project Team Member

Dr. Rene del Valle


Nursing, School of


Health Sciences & Nursing, Gordon E. Inman College of

Document Type

Scholarly Project


Doctorate of Nursing Practice (DNP)

Degree Level


Degree Grantor

Belmont University


contraception, opioid use disorder, substance use disorder, and addiction