‘I Don't Know How to Live Real Life Sober’—Identifying Needed Supports Through the Voices of Pregnant and Parenting People Seeking Recovery

Pregnant and parenting people (PPP) experience complex challenges when seeking recovery from substance use disorders (SUD). Using a community-based participatory research approach, researchers partnered with PPP seeking recovery from SUD to explore supports needed in their communities. Findings are reported in adherence with the consolidated criteria for reporting qualitative research. Thirty PPP were recruited from a residential drug recovery facility in the Southeastern United States. Participant interviews were conducted in-person or virtually. PPP were asked to identify existing and needed parenting and recovery supports in their communities. Interviews were transcribed, verified for accuracy and coded using NVIVO software. Thematic analysis was framed by the Substance Abuse and Mental Health Services Administration (SAMHSA) eight dimensions of wellness, which reflect wellness standards across life domains. Participants identified internal and external challenges including feelings of guilt and shame, treatment access issues, lack of recovery support, grief and loss and inadequate instrumental support. Needed supports were broadly categorised as parenting resources, childcare resources, housing supports, recovery supports, occupational training and assistance and spirituality resources, and then evaluated and sorted based on appropriate fit within the SAMHSA's eight dimensions of wellness. Highest perceived needs fit within Intellectual, Emotional, Spiritual and Environmental wellness dimensions, respectively. Healthcare providers promoting recovery for PPP should focus on support needs within SAMHSA's dimensions of wellness and develop strategies that address the full range of these critical wellness dimensions. Intellectual, emotional and tangible environmental supports including parenting and recovery skills training, accessible mental health care and residential housing with childcare availability are essential for long-term recovery and positive parenting.