Reproductive Health Needs Among Women in Treatment for Substance Use Disorder

Abstract

Integrated care models for substance use disorder (SUD) and reproductive health care have been proposed as a strategy to increase access to reproductive health care for women in treatment for SUD. This cross-sectional, survey-based study measured how women of childbearing age in residential treatment report their demand for and access to reproductive health care, their pregnancy intention, contraceptive utilization and preference for integrating reproductive health care with their current SUD treatment milieu. Eighty-five percent of the women interviewed (N=108) expressed a desire to prevent pregnancy in the next year, although only one-third (33.6%) were using a form of contraception at the time of the study. The majority of women (69%) reported their preference for the integration of contraceptive care and treatment for SUD. If cost was not an issue, 28.7% of women would prefer a long acting reversible contraceptive (LARC) and 40.7% would prefer either injectables, oral contraceptive pills or patches. Improving access to reproductive health for women in treatment for SUD by integrating these services may increase uptake of all methods of contraception and would be well received by most women. Eliciting the preferences of women related to family planning and pregnancy prevention and then responding to those preferences with affordable or no cost access to contraception is a public health imperative. These practice changes stand to improve the myriad health outcomes for women and children associated with unintended pregnancy in the context of SUD

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