256 Identifying causes of parenting stress among postpartum mothers receiving medication for opioid use disorder (MOUD)

Objectives/Goals: Summarize literature on parenting stress and treatment outcomes among postpartum women with opioid use disorder (OUD). Describe the causes of parenting stress identified by postpartum women who received medication for OUD (MOUD) and service providers. Discuss recommendations for parenting support services for postpartum women receiving MOUD in outpatient treatment settings. Methods/Study Population: We will conduct focus groups with postpartum women who received MOUD up to one-year after childbirth (2 groups; n = 10) and service providers (e.g., obstetrics, psychiatry, pediatrics, primary care; 2 groups; n = 10) to identify causes of and contributors to parenting stress to inform the adaptation of a parenting intervention for postpartum women receiving MOUD in an outpatient clinic setting. Participants will be recruited via flyers, email, and social media reach-outs, clinic staff and patient group meetings, and community-based outreach methods. Participants will be compensated for their participation. Focus groups will be audio-recorded and transcribed. Data will be analyzed via rapid analytic procedures using a summary template matrix. Results/Anticipated Results: We will use parenting-related stressors identified by mothers with substance use disorders in previous research to guide our interview questions. We expect to hear participants speak about their knowledge and experiences with stigma, guilt and shame, mental health symptoms, neonatal opioid withdrawal or neonatal opioid withdrawal syndrome (NOWS), fear of being reported to child protective services, and difficulties with mother–infant bonding and attachment. We will also ask participants about structural barriers that are known to increase parenting stress, such as housing instability, financial strain, and availability and cost of childcare. We will also report on new themes that emerge from the data that are shown to increase stress, challenge sobriety, and hinder continued engagement in the treatment. Discussion/Significance of Impact: Discontinuation of MOUD in the postpartum period is high and can lead to opioid recurrence and overdose. Outpatient treatment programs who offer psychiatric and behavioral health care, and parenting programs that target contributors of early postpartum parenting stress could improve health and MOUD treatment outcomes for mothers with OUD.