Society for Medical Anthropology
Oral Presentation Session
A methadone clinic is an unlikely site to demonstrate worthiness to become a mother. For pregnant/parenting women in recovery from opioid use disorders, however, daily attendance at a methadone clinic signals commitment to accepted definitions of recovery and rehabilitation, despite expert disagreement about the safety of methadone during pregnancy. Drawing from Das and Randeria (2015), I describe the symbolic struggles that women engage in to keep custody of their infants and the stigma they face to prove worthiness as parents through navigation of complex systems of prenatal/neonatal care and substance use treatment. The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends that healthcare professionals treat opioid use disorders as a chronic disease, and that they encourage mothers to keep trying and to view relapse as an expected occurrence as they work toward “recovery”. While pharmacologic treatment is considered gold standard for treatment of opioid use disorders during pregnancy, both common options: methadone and buprenorphine, produce NAS symptoms similar to, or more severe than heroin. Pregnant/parenting women in recovery programs are therefore doubly challenged to prove their commitment to the Department of Child Safety, and to parent unusually challenging infants with minimal support. Not losing one’s infant to the foster care system requires daily appointments, across town travel, and impeccable record-keeping to demonstrate improvement. Based on ethnographic research with expectant and new mothers in methadone treatment and their treatment providers, I describe the precarity inherent in preparing for or holding onto motherhood in the context of opioid recovery.