Reproductive healthcare professionals' comfort to treat postpartum patients with substance use disorders

Despite the increasing prevalence of substance use disorders (SUD) in pregnant and postpartum people (PPP), little is known about reproductive healthcare professionals' (RHPs) comfort with SUD counseling, including screening, brief intervention, and referral to treatment (SBIRT). Understanding these factors is essential to improving early identification of SUD and improved care delivery. This study employed a novel Likert-scale survey to assess RHPs' self-reported comfort with the SBIRT approach for PPP. Qualitative data was collected via open ended questions to explore perceptions of necessary training and resources to enhance support for PPPs with SUDs.

We conducted a cross-sectional survey with a national sample of RHPs (n = 117). The survey captured comfort in the SBIRT approach in postpartum patient care delivery via two vignettes and associated Likert scales measuring overall comfort. The survey was assessed for validity and reliability. Analysis of free text responses within the survey explored perceptions of necessary training and resources to improve care delivery.

Participants were mostly White (77.8 %) and female (93.2 %), and ages ranged 22-55 years. The opioid, methamphetamine, and overall comfort scales demonstrated strong internal reliability (Cronbach's α =.83,.81, and.90, respectively). The mean comfort score was 61.35 (SD=10.83). Profession type (p < 0.001), prior SUD-specific training (p = 0.002), and higher SUD patient volume (p < 0.001) were significantly associated with increased comfort. Qualitative themes emphasized the need for expanded perinatal SUD education, stigma reduction, and integrated, trauma-informed care to reduce resource gaps in postpartum screening, mental health services, and peer support programs.

Health professionals report a need for expanded access to postpartum-specific SUD training and increased referral options to assist patients.

Future interventions to increase the comfort and capacity of RHPs for screening, briefly intervening, and referring postpartum patients with SUD are necessary to improve care delivery for this high-risk population.