Session: Social Work Approaches to Perinatal Substance Use (Society for Social Work and Research 31st Annual Conference)

Background: Perinatal substance use is a critical public health issue in the United States and is associated with increased risks for adverse maternal and infant outcomes, including maternal and infant mortality. For social work practitioners and policymakers, perinatal substance use represents a complex challenge at the intersection of healthcare, child welfare, and behavioral health systems in which policy responses often shape who is supported and who is marginalized. Addressing perinatal substance use requires rigorous, inclusive research, which prioritizes equity, integrates lived experience, and informs compassionate, evidence-based policy and practice. Existing research has often framed substance use during pregnancy through narrow, punitive, and risk-focused lenses, frequently overlooking lived experience, and the broader social, structural, and historical contexts shaping risk.

Methods: This symposium integrates findings from three studies to examine perinatal substance use through intervention, population-level evidence, and community-engaged research. Together, the presentations document disparities and gaps in existing U.S. research on infant mortality, highlight the benefits of trauma-informed, relationship-based supports for pregnant and postpartum people, and center lived experience to inform non-punitive, equity-focused models of perinatal care.

Results: The first presentation will report findings from a scoping review examining U.S.-based research on the relationship between perinatal substance use and infant mortality, examining how risk is conceptualized and measured across the literature. The authors synthesized findings from twelve empirical studies. The review found consistent evidence linking perinatal substance use to increased infant mortality risk. This scholarly work advances social work’s role in generating evidence to inform policies and practices that promote dignity and reduce harm.

The second presentation will describe a community-based participatory research project that examined perinatal substance use in a rural state, aiming to understand the lived experiences of pregnant people who used substances and to identify trusted, trauma-informed pathways into perinatal care through an academic–community partnership. Seven participants with lived experience and family perspectives engaged in weekly focus groups, which contributed to the co-creation of a four-component model of care focused on systemic change.

The final presentation will report on a qualitative post-treatment study of Building Resilience through Intervention: Growing Healthier Together (BRIGHT), a perinatal dyadic parenting intervention for mothers with opioid use disorder (OUD) delivered by social workers from pregnancy through six months postpartum. Drawing on interviews with 19 mothers enrolled in a pragmatic randomized controlled trial, the study explores participants’ experiences, clinician relationships, and perceived impacts on parenting. Overall, findings suggest BRIGHT is an acceptable and beneficial intervention.

Implications: Aligned with this year’s conference theme, Social Work Research at the Service of Democracy: Advancing Rigorous Inquiry for the Common Good, this symposium highlights democratic values of inclusivity, justice, and compassion by centering the needs and perspectives of those most impacted by perinatal substance use. A content expert will discuss how these projects are examples of grounding social work policies and practices (e.g., community-based approaches and dyadic interventions) in the experiences of people with perinatal substance use disorder and how to support social work professionals co-create non-punitive, equity-focused approaches that help families and communities thrive.