Date of Degree


Document Type


Degree Name



Social Welfare


Diane E. Depanfilis

Committee Members

Alexis Kuerbis

Daniel Herman

Subject Categories

Social Justice | Social Work


mothers in methadone assisted treatment, SAMHSA guidance, neonatal abstinence syndrome, neonatal opioid withdrawal syndrome, mixed methods qualitative analysis


In response to the increasing rates of opioid exposure among pregnant women and their infants, the Substance Abuse and Mental Health Services Administration (SAMHSA) published “Clinical Guidance for Treating Pregnant Women with Opioid Use Disorder and Their Infants” (2018). The expert panel, which was assembled for this clinical guidance did not include women who were the focal subjects for the guidance. The current qualitative study contributed the missing voices of women in methadone-assisted treatment (MAT) who gave birth subsequent to the publication of the guidance.

The SAMHSA guidance was based upon a preponderance of evidence guiding recommended practices regarding rooming-in, breastfeeding, and positive relationships with healthcare providers, such as nurses and lactation consultants. Women in MAT who gave birth subsequent to the publication of the guidance described their experiences and identified recommended practices. The researcher employed narrative, descriptive/thematic, and comparative analyses to conclude the following: Current practices affected the women’s caregiving opportunities. The women’s recommendations largely aligned with those of the SAMHSA guidance. However, their experiences did not align with the recommended practices.

The researcher identified the need for systemic approaches to implementing the clinical guidance.