"I'm not a bad mother:" the experience of stigma among mothers with substance use disorder in the criminal justice system.

Abstract

This study explores the impacts of stigma on the lives of pregnant and parenting women with substance use disorder (SUD) and justice involvement. We also uncover how some women were able to cope with adversity and take steps to develop resilience. To guide our research, we combined Bos and colleagues' stigma theory with Windle's concept of resilience. Semi-structured interviews were conducted with 20 pregnant or parenting women in Western New York to uncover the contextual factors influencing care, resources, and social support. Our findings suggest that the presence of stigma hinders pregnant and parenting women's access to resources, care, and treatments while reinforcing marginalization, isolation, and continued substance use. Despite these challenges, some participants found ways to navigate and mitigate stigma while promoting resilience. Protective factors and strategies included: maintaining a positive motherhood identity, leveraging social support often outside the nuclear family, and having access to supportive, compassionate justice system resources. Understanding the strategies women with SUD use to overcome adversity can inform approaches that judges, case workers, and health care providers can use to engage and support women in recovery and reduce their experience of stigma.