Silent Struggles: Unveiling Stigma in Healthcare With Perinatal Patients on Medication for Opioid Use Disorder

Perinatal opioid use disorder contributes significantly to the U.S. maternal health crisis. Medication for opioid use disorder (MOUD) improves maternal and neonatal outcomes, yet stigma remains a barrier to care for pregnant patients. This qualitative study examined stigma experienced by perinatal patients on MOUD and its impact on healthcare engagement using the Health Stigma and Discrimination Framework. Semi-structured interviews were conducted with 15 patients receiving integrated perinatal and addiction care in Philadelphia, Pennsylvania, between October 2023 and April 2025. Participants were aged 24–40 years; 47% identified as Black and 53% as White. Thematic analysis identified key drivers of stigma including societal judgments of parental fitness, fear of state involvement, and provider knowledge gaps regarding MOUD. Stigma manifested as inadequate pain management, fear of custody loss, and reduced care-seeking behaviors. Findings underscore the need for provider education and policy reform to reduce punitive responses to MOUD use in pregnancy.