Intersectional Stigma and Infant Feeding in Childbearing Women With Opioid Use Disorder

Opioid use disorder (OUD) in childbearing women is a complex multilayered public health concern that creates increased vulnerability for affected women and infants, placing them at risk for stigmatization. The role of intersectional stigma is not well understood in the context of OUD and mothering; however, it may have implications for health-related behaviors such as infant feeding. The aim of this study was to understand how intersecting stigmas influence the infant feeding choices of childbearing women with OUD. Using an intersectional lens, this study highlights how multiple stigmas related to their diagnosis and role as mothers converge and affect decisions regarding infant feeding. We conducted a secondary analysis of semistructured individual interviews from 14 participants who were mothers of infants treated for Newborn Opioid Withdrawal Syndrome. The original study was a qualitative, multiple case study analysis of infant feeding experiences of mothers receiving medication for OUD. Interview data were analyzed using qualitative content analysis. Three overarching themes revealed mothers' awareness of the stigma attached to mothering with OUD: (a) you have to go that extra mile, (b) everybody has their reasons, and (c) just do what you got to do. The mothers' assignment of good mothering behaviors based on infant feeding choice further underscored their perceived stigma. Understanding the intersections between OUD-related stigma within the context of mothering may provide opportunities to better support infant feeding choices in childbearing women with OUD.