Navigating recovery: a scoping review of comprehensive approaches to postpartum substance use care and support
Bibliographic record
Abstract
BACKGROUND: Unregulated drug use, including non-prescription opioids, is a growing public health problem in Canada and the United States, compounded by a toxic drug supply and rising overdose rates. Perinatal women, particularly in the postpartum period, face increased risks, with overdose now a leading cause of maternal mortality. Despite these risks, research has largely focused on substance use during pregnancy, with limited attention to the postpartum period. Understanding the experience of postpartum women who use unregulated drugs and/or non-prescription opioids, including their recovery experience, is essential for designing supportive care. Therefore, the purpose of this scoping review was to map the current body of evidence on the experiences of postpartum women with a history of unregulated drug and/or non-prescription opioid use, including their recovery experiences where reported. METHODS: This scoping review used Arksey and O'Malley's five-step framework to systematically map the available literature. A search of six databases and relevant websites was used to identify primary research published between 2013 and 2024. The articles were screened using defined inclusion and exclusion criteria and thematic analysis was used to identify key themes. RESULTS: The analysis of 11 studies that met the inclusion criteria resulted in the identification of four themes related to the experience of recovery: (1) Positive and negative aspects of diverse relationships, (2) The pivotal role of motherhood and the mother-child bond, (3) Cultivating self-related factors, and (4) Navigating barriers and seeking support for improved health outcomes. CONCLUSIONS: Substance use recovery during the postpartum period is shaped by both external relationships and self-related factors. Recovery programs that support women in navigating diverse relationships while also fostering internal factors such as self acceptance, self-efficacy, and resilience are needed. Access to comprehensive, integrated care is essential, particularly care that prioritizes keeping mothers and children together and includes peer support.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.067 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.006 |
| Bibliometrics | 0.028 | 0.029 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.006 | 0.005 |
| Open science | 0.003 | 0.006 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".