Health Care Encounters of Pregnant and Postpartum Women with Substance Use Disorders.

The purpose of this review is to describe how pregnant and postpartum women with substance use disorders (SUDs) experience health care encounters in prenatal care, labor and delivery, postpartum, and nursery/neonatal intensive care unit (NICU) settings. Findings from 23 qualitative studies on the topic were synthesized using a metasummary approach. The majority of the studies revealed that pregnant and postpartum women with SUDs tend to experience their health care encounters as conflictual, although some studies revealed that some women experience their health care encounters as supportive. The results of metasummary included a taxonomy of health care encounters. Five types of adverse encounters were identified: judgmental, disparaging, scrutinizing, disempowering, and deficient-care. Three types of beneficial encounters were identified: recovery-based, accepting, and effective-care. The findings suggest the importance of stigma awareness, therapeutic patient-provider communication, patient activation, and integrated care.