Moral distress (MD) is a concept that has been well studied in nursing and other medical fields as a precursor to provider burnout. Understanding how MD impacts behavioral health (BH) clinicians provides insights for counselor educators and supervisors to identify clinical situations that often lead to MD. This qualitative phenomenological study explored how MD was experienced by five BH clinicians who have worked in residential and hospital settings providing counseling to maternal, opioid-using clients. Interpretive phenomenological analysis (IPA) informed the research methodology and data analysis. Substance use during pregnancy is highly stigmatized in society; thus, a feminist conceptualization was integrated as the theoretical framework. Themes centered on specific systems that cause MD when working with the population, ways to mitigate MD (including advocating against bias towards maternal, opioid using women), and how personal and professional experience impacted the clinician’s experiences of MD situations as providers and organization leaders. The study\u27s outcomes provide a foundation for future research to explore MD as it relates to the impact MD has on BH clinicians. Recommendations include integrating information about MD in formal and continuing counselor education and further exploring how those in leadership positions identify and approach MD. Like other health care professions, the counseling profession is experiencing post-pandemic stresses and workforce shortages. Understanding MD is pivotal to training and retaining healthy counseling practitioners