Grounded Theory Approach to Understand Self-Management of Opioid Recovery Through Pregnancy and Early Parenting

Objective: To develop a theory to explain the processes women use to self-manage recovery from opioid use disorder during pregnancy, the postpartum period, and early parenting. Design: Constructivist grounded theory approach. Participants: Women (N 1/4 16) who gave birth during the past 12 months and used medication for opioid use disorder for recovery through pregnancy and the postpartum period. Methods: We recruited participants through seven medication-assisted treatment clinics in a mid-size Midwestern city and the surrounding suburbs and through online parenting and recovery community groups with national-based memberships. We conducted semistructured, individual audio interviews from November 2020 to July 2021. Interviews continued until we reached theoretical and meaning saturation. We used constant comparative methods during initial and intermediate coding. Results: Participants described a central process, Growing asa Healthy Dyad, that included six processes they used to self-manage recovery: Maintaining Vigilance, Performing Self-Care, Putting in the Work of Recovery, Advocating, Navigating Social Support, and Acquiring Skills and Knowledge. These processes were affected by personal and social contextual factors. Conclusions: The grounded theory, Self-Management of Opioid Recovery Through Pregnancy and Early Parenting, can be used to explain the unique processes of self-management by women in opioid recovery and highlights the need for a strengths-based approach to caring for the maternal-infant dyad.