Abstract: Experiences of Substance Use Coercion Among Postpartum Women in Recovery (Society for Social Work and Research 26th Annual Conference - Social Work Science for Racial, Social, and Political Justice)

114P Experiences of Substance Use Coercion Among Postpartum Women in Recovery

Thursday, January 13, 2022
Marquis BR Salon 6, ML 2 (Marriott Marquis Washington, DC)
* noted as presenting author
Rachel Fusco, PhD, Associate Professor, University of Georgia, Athens, GA
Shanti Kulkarni, Professor, UNC Charlotte
Background/ Purpose: Coercive control has been identified as a critical factor in abused women’s
economic, educational, and reproductive lives. A survey of callers to the National Domestic Violence
Hotline found that almost 30% reported a current or ex-partner pressured them to use alcohol or drugs,
or made them use more than they wanted. Given the high co-occurrence of substance use and intimate
partner violence (IPV), more focus is needed on how intimate partners may affect not only women’s use
of drugs and alcohol, but efforts to achieve and maintain substance use abstinence. The current
research focuses on the role of coercion by an intimate partner in women’s substance use and recovery.
This study involves postpartum women to better understand the complex relationship between
pregnancy, substance use, and partner violence. There are no known studies looking at substance use
coercion among postpartum women, or at how their coercion may impact women’s recovery.
Methods: Women were recruited for interviews from an intervention study providing home visiting to
postpartum women in substance use recovery (N=33). All participants who reported having a current
male partner (N=29) were asked to participate in qualitative interviews. All of the women gave birth
within the past year and retained primary custody of their infants. Women’s ages ranged from 22 to 34
years old. Twenty-six of their partners were the baby’s biological father, and all partners had substance
use problems. This was the first birth for 22 of the mothers.
A semistructured interview protocol based on the work of Warshaw and colleagues (2014) was
developed for the study. Interviews were audio recorded and transcribed verbatim. Process and content
memos were generated during the data collection period to document observations and develop
preliminary hypotheses.
Transcripts were analyzed using multiple strategies to investigate the experiences of postpartum women
with substance use problems in the context of their intimate relationships. Interviews were first read in
their entirety to generate a condensed narrative of women’s experiences within a contextual frame and
to begin to identify potential codes and themes. Second, data were imported into qualitative software
(NVivo 8) for coding. Open (i.e., unrestricted) coding was used to reduce the data, identify initial
themes, and organize interview verbatim for further analysis. Inductive and deductive approaches were
used to determine coding categories.
Results: Women described ways their partners challenged their recovery process through coercive
control, with a range of tactics employed. Emergent themes included: “relationship was conditional on
substance use”, “reinforcing identity as a ‘bad mother’”, “sabotaging sobriety”, and “sabotaging
Conclusions and Implications: The current study showed different ways that intimate partners impacted
substance use and efforts to maintain sobriety. Many women spoke of partners being mostly supportive
of abstinence during pregnancy, but applying pressure to use again after the baby’s birth. Findings
highlight the importance of supporting women with substance use problems during pregnancy and after
the baby’s birth. Implications for co-locating IPV services with substance use services will be discussed,
along with efforts to support partners in their own treatment when appropriate.