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      Mothers at the Intersection of Trauma, Addiction, and Involvement with the Criminal Legal System: An Analysis of Multiple Case Studies

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          Abstract

          The study focuses on the complex interconnection of race, sexuality, and socioeconomic background in shaping the stories of mothers struggling with addiction disorders as they attempt to recover from traumatic experiences. A sample of 45 mothers was employed in the study. Using case study analysis methodologies, the stories of 6 mothers were used as representative cases based on their individual characteristics, community settings, and institutional experiences. Further, the 6 cases were used to describe the difficulties experienced by participants across 3 major life transitions: (1) childhood (2) initiation to drug use and addiction disorders (3) motherhood. Across these life transitions, participants emphasized the relevance of traumatic experiences and mental health disorders as main reasons for their drug addiction. For each theme highlighted in the narrative of each case, a connection to all other participants was made to summarize the findings in the whole sample. The analysis indicates that while most mothers experienced trauma during their lifetime, mothers who identified as members of racial/ethnic minorities and those who identified as lesbians were more likely to report trauma from prejudice and discrimination. Furthermore, the analysis highlights that mothers who identified as members of racial minorities were more likely to have their children placed in foster care. In the study, mothers’ involvement with the criminal legal system contributed to the challenges they experienced while renegotiating their relationships with their children. These mothers’ lived experiences and the complexity of the dynamics they described—especially their interactions with the legal system—could potentially help other researchers frame new hypotheses that could be tested by larger empirical studies.

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          Most cited references40

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            Pregnant women and substance use: fear, stigma, and barriers to care

            Background Substance use during pregnancy and motherhood is both a public health and criminal justice concern. Negative health consequences associated with substance use impact both the mother and the developing fetus, and there are ongoing attempts to criminalize substance use during pregnancy that put pregnant substance-using women at risk of detection, arrest, and punishment. This study explored the experiences of substance-using mothers as they navigated health and criminal justice consequences and accessed needed resources in the community. Methods In-depth life history interviews were conducted with 30 recently-pregnant women who had used alcohol or other drugs during their pregnancies. The three-part interview schedule included questions about past and current substance use, life history, and experiences with criminal justice authorities, child protective services, and health professionals. Results Women’s stories highlighted their strategies for managing their risk of detection by health or criminal justice authorities, including isolating themselves from others, skipping treatment appointments, or avoiding treatment altogether. Women described multiple barriers to treatment and healthcare, including a lack of suitable treatment options and difficulty finding and enrolling in treatment. Conclusion The findings suggest that policies that substance-using women find threatening discourage them from seeking comprehensive medical treatment during their pregnancies. The implications of the findings are discussed, particularly the need for further expansion of treatment programs and social services to meet the needs of substance-using women.
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              Self-reported Medical and Nonmedical Cannabis Use Among Pregnant Women in the United States

              This study uses National Survey on Drug Use and Health data to examine prevalence and frequency of medical and nonmedical cannabis use among pregnant and nonpregnant women between 2013 and 2017.
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                Author and article information

                Journal
                Inquiry
                Inquiry
                INQ
                spinq
                Inquiry: A Journal of Medical Care Organization, Provision and Financing
                SAGE Publications (Sage CA: Los Angeles, CA )
                0046-9580
                1945-7243
                3 February 2025
                Jan-Dec 2025
                : 62
                : 00469580251317657
                Affiliations
                [1 ]Indiana University Northwest, Gary, Indiana, USA
                Author notes
                [*]Monica Solinas-Saunders, School of Public and Environmental Affairs, Indiana University Northwest, 3400 Broadway, Gary, Indiana 46408, USA. Email: msolinas@ 123456iu.edu
                Author information
                https://orcid.org/0000-0003-2625-6496
                Article
                10.1177_00469580251317657
                10.1177/00469580251317657
                11789102
                39895302
                1d1b361b-7348-4333-a72b-d46e95eb1752
                © The Author(s) 2025

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 23 October 2024
                : 14 December 2024
                : 17 December 2024
                Funding
                Funded by: indiana university, FundRef https://doi.org/10.13039/100006733;
                Categories
                Original Research
                Custom metadata
                January-December 2025
                ts1

                mothers’ addiction,child protective services,criminal legal system’s response to addiction,mental health problems and addiction disorders,motherhood,traumatic experiences,trauma,drug and alcohol addiction,qualitative research,case study analysis,multiple case study analysis

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