Postpartum Experiences of Women With a History of Trauma and Substance Use Disorders

Purpose: To explore how relational, health care, and sociocultural systems shape mental health and distress management in postpartum women with trauma and substance use histories. Method: Using a qualitative design informed by phenomenological sensibility and ecological systems theory, we conducted semi-structured interviews with seven women who had given birth within the past 5 years and self-disclosed a history of trauma, and self-identified as sober. Results: Reflexive thematic analysis generated seven themes organized across five ecological systems levels: Perception of Mental Health and Emotional States and Motivation for Coping (microsystem ); Relational Experiences Impacting Sense of Self (mesosystem); Experiences With Health Care Professionals (exosystem); Cultural Expectations (macrosystem); and Historical Trauma and Ideal Health Care Experiences (chronosystem). Conclusion: Mental health nurses should deliver ecologically informed, trauma-informed, and culturally responsive care across postpartum settings. Nurses are uniquely positioned to recognize behavioral patterns, including masking, relational withdrawal, and readiness disruption, which characterize this population's engagement with care.