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Abstract

Women in recovery from addiction experience significant sociostructural barriers to reestablishing self, family, and home after having a baby. The aim of this grounded theory study was to describe pathways that women and their families followed and how transitions were experienced in the early years after receiving services through an integrated community-based maternity program. Eighteen women completed questionnaires and participated in a series of semistructured interviews over 2 years. The overall process women experienced was that of holding it together, which women did by restoring their sense of self during recovery, becoming a strong center for their family, and creating a sense of home no matter what the circumstances. Key elements supporting women in their transition to recovery and parenthood included longer term health, social, and recovery programs and services that addressed determinants of health (in particular, gender, housing, and income), and receiving support provided from strengths-based perspectives.

Keywords

substance use recovery mothers child-bearing/child-rearing early years grounded theory

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References

Bennett

(2008). Jumping through hoops: A Manitoba study examining experiences and reflections of Aboriginal mothers involved with child welfare in Manitoba. In McKay

Fuchs

Brown

(Eds.), Passion for action in child and family services: Voices from the prairies (pp. 69-98). Regina, Saskatchewan: Canadian Plains Research Center. Retrieved from http://cwrp.ca/publications/1129

Benoit

Magnus

Phillips

Marcellus

Charbonneau

(2015). Complicating the dominant morality discourse: Mothers and fathers’ constructions of substance use during pregnancy and early parenthood. International Journal for Equity in Health, 14, Article 72. doi:10.1186/s12939-015-0206-7

Blumer

(1969). Symbolic interactionism: Perspective and method. Berkeley, CA: University of California Press.

Brown

(2004). A place called self: Women, sobriety, and radical transformation. Center City, MN: Hazelden.

Canada FASD Research Network’s Action Team on FASD Prevention from a Women’s Health Determinants Perspective. (2012). Supporting pregnant and parenting women who use substances: What communities are doing to help. Retrieved from http://canfasd.ca/researchers/prevention/

Charmaz

(2014). Constructing grounded theory (2nd ed.). Thousand Oaks, CA: Sage.

Chasey

Pederson

Duff

(2009). Taking a second look: Analyzing health inequities in British Columbia with a sex, gender, and diversity lens. Vancouver, Canada: British Columbia Center of Excellence for Women’s Health. Retrieved from http://bccewh.bc.ca/2014/02/taking-a-second-look-analyzing-health-inequities-in-british-columbia-with-a-sex-gender-and-diversity-lens/

Courtney

McMurtry

Zinn

(2004). Housing problems experienced by recipients of child welfare services. Child Welfare, 83, 393-422.

Covington

(2002). Helping women recover: Creating gender-responsive treatment. In Straussner

Brown

(Eds.), The handbook of addiction treatment for women: Theory and practice (pp. 26-51). San Francisco, CA: Jossey-Bass.

10.

Ettore

(2007). Revisioning women and drug use: Gender, power and the body. New York, NY: Palgrave Macmillan.

11.

Evans

Pierce

Hser

Y.-I.

(2013). Explaining long-term outcomes among drug dependent mothers treated in women-only versus mixed-gender programs. Journal of Substance Abuse Treatment, 45, 293-301. doi:10.1016/j.jsat.2013.04.003

12.

Glaser

Strauss

(1967). The discovery of grounded theory. New Brunswick, NJ: Aldine.

13.

Grant

Huggins

Graham

Ernst

Whitney

Wilson

(2011). Maternal substance abuse and disrupted parenting: Distinguishing mothers who keep their children from those who do not. Children and Youth Services Review, 33, 2176-2185. doi:10.1016/j.childyouth.2011.07.001

14.

Graziotti

Hammond

Messinger

Bann

Miller-Loncar

Twomey

. . . Alexander

(2012). Maintaining participation and momentum in longitudinal research involving high-risk families. Journal of Nursing Scholarship, 44, 120-126. doi:10.1111/j.1547-5069.2012.01439.x

15.

Greaves

Varcoe

Poole

Morrow

Johnson

Pederson

Irwin

(2002). A motherhood issue: Discourses on mothering under duress. Ottawa, Ontario: Status of Women Canada. Retrieved from http://www.cwhn.ca/en/node/22718

16.

Greenfield

Brooks

Gordon

Green

Kropp

McHugh

. . . Miele

(2007). Substance abuse treatment entry, retention, and outcome in women: A review of the literature. Drug and Alcohol Dependence, 86, 1-21. doi:10.1016/j.drugalcdep.2006.05.012

17.

Greenfield

Cummings

Kuper

Wigderson

Koro-Ljungberg

(2013). A qualitative analysis of women’s experiences in single-gender versus mixed-gender substance abuse group therapy. Substance Use & Misuse, 48, 772-782. doi:10.3109/10826084.2013.787100

18.

Gueta

Addad

(2015). A house of cards: The long-term recovery experience of former drug-dependent Israeli women. Women’s Studies International Forum, 48, 18-28. doi:10.1016/j.wsif.2014.10.003

19.

Gultekin

Brush

(2016). In their own words: Exploring family pathways to housing instability. Journal of Family Nursing, 23, 90-115. doi:10.1177/1074840716678046

20.

Gultekin

Brush

Baiardi

Van Maldegham

(2014). Voices from the street: Exploring the realities of family homelessness. Journal of Family Nursing, 20, 390-414. doi:10.1177/1074840714548943

21.

Hines

(2012). The treatment views and recommendations of substance abusing women: A meta-synthesis. Qualitative Social Work, 12, 473-489. doi:10.1177/1473325011432776

22.

Hser

Longshore

Anglin

(2007). The life course perspective on drug use: A conceptual framework for understanding drug use trajectories. Evaluation Review, 31, 515-547. doi:10.1177/0193841X07307316

23.

Huxley

Foulger

(2008). Parents who misuse substances: Implications for parenting practices and treatment seeking behaviour. Drugs and Alcohol Today, 8(3), 9-16. doi:10.1108/17459265200800020

24.

Kapur

(2011). Pregnancy: A window of opportunity for improving current and future health. International Journal of Gynecology & Obstetrics, 115(Suppl. 1), S50-S51. doi:10.1016/S0020-7292(11)60015-5

25.

Keating-Lefler

Wilson

(2004). The experience of becoming a mother for single, unpartnered, Medicaid-eligible, first-time mothers. Journal of Nursing Scholarship, 36, 23-29. doi:10.1111/j.1547-5069.2004.04007.x

26.

Kelly

White

(2016). Recovery management and the future of addiction treatment and recovery in the USA. In Kelly

White

(Eds.), Addiction recovery management: Theory, research and practice (pp. 303-316). New York, NY: Springer.

27.

Kruk

Banga

(2011). Engagement of substance-using pregnant women in addiction recovery. Canadian Journal of Community Mental Health, 30, 79-91. doi:10.7870/cjcmh-2011-0006

28.

Lander

Howsare

Byrne

(2013). The impact of substance use disorders on families and children: From theory to practice. Social Work and Public Health, 28, 194-205. doi:10.1080/19371918.2013.759005

29.

Mackintosh

Knight

(2012). The notion of self in the journey back from addiction. Qualitative Health Research, 22(8), 1094-1101. doi:10.1177/1049732312450325

30.

Marcellus

MacKinnon

Benoit

Phillips

Stengel

(2014). Redefining indicators of success for programs supporting pregnant women with problematic substance use. Qualitative Health Research, 25, 500-512. doi:10.1177/1049732314551058

31.

Motz

Leslie

Pepler

Moore

Freeman

(2006). Breaking the cycle: Measures of progress 1995-2005. Journal of FAS International, 4, e22. Retrieved from http://www.motherisk.org/JFAS_documents/BTC_JFAS_ReportFINAL.pdf

32.

Neale

Nettleton

Pickering

(2012). The everyday lives of recovering heroin users. London, England: RSA. Retrieved from www.drugsandalcohol.ie/18631/1/RSA_Everyday_lives.pdf

33.

Niccols

Milligan

Smith

Sword

Thabane

Henderson

(2012). Integrated programs for mothers with substance abuse issues and their children: A systematic review of studies reporting on child outcomes. Child Abuse & Neglect, 36, 308-322. doi:10.1016/j.chiabu.2011.10.007

34.

Olmstead

White

Sindelar

(2004). The impact of managed care on substance abuse treatment services. Health Services Research, 39, 319-344. doi:10.1111/j.1475-6773.2004.00230.x

35.

Pauly

MacKinnon

Varcoe

(2009). Revisiting “who gets care?” Health equity as an arena for nursing action. Advances in Nursing Science, 32, 118-127. doi:10.1097/ANS.0b013e3181a3afaf

36.

Poole

(2000). Evaluation report of the Sheway Project for high-risk, pregnant and parenting women. Vancouver, Canada: British Columbia Centre of Excellence for Women’s Health. Retrieved from http://bccewh.bc.ca/2014/02/evaluation-report-of-the-sheway-project-for-high-risk-pregnant-and-parenting-women/

37.

Poole

Isaac

(2001). Apprehensions: Barriers to treatment for substance using mothers. Vancouver, Canada: British Columbia Centre of Excellence for Women’s Health. Retrieved from http://bccewh.bc.ca/2014/02/apprehensions-barriers-to-treatment-for-substance-using-mothers-2/

38.

Racine

Motz

Leslie

Pepler

(2009). Breaking the Cycle Pregnancy Outreach Program: Reaching out to improve the health and well-being of pregnant substance-involved mothers. Journal of the Motherhood Initiative for Research and Community Involvement, 11, 279-290. Retrieved from https://jarm.journals.yorku.ca/index.php/jarm/article/view/22525/21005

39.

Radcliffe

(2011). Motherhood, pregnancy, and the negotiation of identity: The moral career of drug treatment. Social Science & Medicine, 72, 984-991. doi:10.1016/j.socscimed.2011.01.017

40.

Salmon

Ham

(2008). The impact of MEIA-funded supports on client outcome at Sheway. Vancouver, Canada: British Columbia Centre of Excellence for Women’s Health. Retrieved from http://sheway.vcn.bc.ca/files/2012/07/The-Impact-of-MEIA-Funded-Supports-on-Client-Outcome-at-Sheway.pdf

41.

Schreiber

Stern

(2001). Using grounded theory in nursing. New York, NY: Sage.

42.

Shahram

Bottorff

Kurtz

Oelke

Thomas

Spittal

(2016). Understanding the life histories of pregnant-involved young Aboriginal women with substance use experiences in three Canadian cities. Qualitative Health Research, 27, 249-259. doi:10.1177/1049732316657812

43.

Silva

Pires

Guerreiro

Cardoso

(2012). Balancing motherhood and drug addiction: The transition to parenthood of addicted mothers. Journal of Health Psychology, 18, 359-367. doi:10.1177/1359105312443399

44.

Smith

(2012, November 22). The tragedy of children condemned with drug addict parents. Daily Mail. Retrieved from http://www.dailymail.co.uk/debate/article-2085711/Tragedy-Children-condemned-drug-addict-parents.html

45.

Smith

(2006). Empowering the “unfit” mother: Increasing empathy, redefining the label. Affilia: Journal of Women and Social Work, 21, 448-457. doi:10.1177/0886109906292110

46.

Sprague

(2005). Feminist methodologies for critical researchers: Bridging differences. Walnut Creek, CA: AltaMira.

47.

Stengel

(2014). The risk of being “too honest”: Drug use, stigma and pregnancy. Health, Risk & Society, 16, 36-50. doi:10.1080/13698575.2013.868408

48.

Substance Abuse and Mental Health Services Administration. (2012). SAMHSA’s working definition of recovery. Retrieved from https://blog.samhsa.gov/2012/03/23/defintion-of-recovery-updated/

49.

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (2014, April 3). The TEDS Report: Gender differences in primary substance of abuse across age groups. Rockville, MD. Retrieved from http://archive.samhsa.gov/data/2k14/TEDS077/sr077-gender-differences-2014.htm

50.

Sutherland

(2010). Mothering, guilt and shame. Sociology Compass, 4, 310-321. doi:10.1111/j.1751-9020.2010.00283.x

51.

Sword

Jack

Niccols

Milligan

Henderson

Thabane

(2009). Integrated programs for women with substance use issues and their children: A qualitative meta-synthesis of processes and outcomes. Harm Reduction Journal, 6, Article 32. doi:10.1186/1477-7517-6-32

52.

Terplan

Kennedy-Hendricks

Chisolm

(2015). Prenatal substance use: Exploring assumptions of maternal unfitness. Substance Abuse: Research and Treatment, 9(S2), 1-4. doi:10.4137/SART.S23328

53.

Torchalla

Linden

Strehlau

Neilson

Krausz

(2015). “Like a lots happened with my whole childhood”: Violence, trauma, and addiction in pregnant and postpartum women from Vancouver’s Downtown Eastside. Harm Reduction Journal, 11, Article 34. doi:10.1186/1477-7517-11-34

54.

Tuchman

(2010). Women and addiction: The importance of gender issues in substance abuse research. Journal of Addictive Diseases, 29, 127-138. doi:10.1080/10550881003684582

55.

Turner

(2016). Insights on Canadian society: Living arrangements of Aboriginal children aged 14 and under. Retrieved from http://www.statcan.gc.ca/pub/75-006-x/2016001/article/14547-eng.htm

56.

Vilches

(2011). Dreaming a way out: Social planning responses to the agency of lone mothers experiencing neo-liberal welfare reform in Western Canada (Unpublished doctoral dissertation). University of British Columbia, Vancouver, Canada.

57.

Wiig

E. M.

Haugland

B. S. M.

Halsa

Myhra

(2017). Substance-dependent women becoming mothers: Breaking the cycle of adverse childhood experiences. Child & Family Social Work, 22, 26-35. doi:10.1111/cfs.12190

58.

Wodinski

Wanke

Khan

(2013). Impact evaluation of the H.E.R. Pregnancy Program: Final summary report. Edmonton, Alberta, Canada: Charis Management Consulting for the Alberta Centre for Child, Family and Community Research. Retrieved from https://fasdprevention.wordpress.com/2014/02/07/impact-evaluation-of-the-healthy-empowered-and-resilient-h-e-r-pregnancy-program-in-edmonton-alberta/

A Grounded Theory of Mothering in the Early Years for Women Recovering From Substance Use

Abstract

Keywords

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