Pregnant and Afraid: Opioid-Using Expectant Mothers Facing Injustices in Rural Appalachia
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The United States Food and Drug Administration first approved several opioids—oxycodone, hydrocodone, codeine, etc.—for prescription use in the late 20th century. What started as simple, effective painkillers quickly led to a nationwide addiction epidemic, perhaps creating more problems than it solved. In the case of pregnant women, both mother and unborn child face the effects of addiction. The newborn often suffers from Neonatal Abstinence Syndrome, a condition frequently associated with motor-disabilities, upon birth. Many pregnant women in rural Appalachia face a myriad of additional problems including, but not limited to, finding available treatment providers, facing charges from the criminal justice system, and receiving care for underlying childhood traumatic experiences. Though the roots of this crisis require action on a national level, I address the injustices facing rural mothers already caught in the cycle of addiction and present solutions for diminishing them. To expand the accessibility and effectiveness of opioid agonist treatment (OAT) for expectant mothers residing in rural Appalachia and improve outcomes for both mother and newborn, rural primary care physicians should become DATA-waivered buprenorphine prescribers, politicians should avoid legislature that criminalizes the mother, and treatment facilities should integrate a trauma-informed care (TIC) environment.