{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T04:47:01Z","timestamp":1791780421220,"version":"4.3.4"},"reference-count":14,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In Colorado, suicide and accidental overdose are the two leading causes of death among pregnant and postpartum individuals. People with substance use disorders report mistreatment in hospital settings, yet there is limited understanding of healthcare providers' perspectives on this issue. The study aimed to investigate hospital staff perspectives on the treatment of patients in\/around labor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We surveyed 26 birthing hospitals in Colorado that are part of the Colorado Perinatal Care Quality Collaborative's substance use quality improvement initiative. 193 individuals from 19 frontier, rural, and urban hospitals responded. We collected quantitative data on attitudes and behaviors toward patients and conducted an exploratory qualitative analysis to further understand these attitudes and behaviors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Respondents reported that their colleagues, and to a lesser extent, themselves, exhibit negative attitudes and behaviors when caring for patients with substance use disorders. Common issues highlighted biases, stereotypes, and gaps in unit\u2010level management of these patients. The qualitative analysis revealed five themes: 1. Negative discussions about patients in professional settings, 2. Judgment and mistrust from staff, 3. Rudeness or dismissiveness from nurses, 4. Concerns about child custody, and 5. Inadequate clinical care. Respondents requested specific training in perinatal substance use care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study characterizes the attitudes and behaviors of birthing hospital staff toward patients with substance use disorders from the healthcare provider's perspective. The findings demonstrate persistent negative attitudes and behaviors and underscore the need for enhanced education to prepare obstetric\/neonatal healthcare providers to better support this vulnerable patient population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/birt.70123","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T04:26:39Z","timestamp":1791779199000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Multi Method Analysis of the Treatment of Perinatal Patients With Substance Use Disorders"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0513-7308","authenticated-orcid":false,"given":"K. S.","family":"Swenson","sequence":"first","affiliation":[{"name":"Colorado Perinatal Care Quality Collaborative  Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4790-3982","authenticated-orcid":false,"given":"S.","family":"Comstock","sequence":"additional","affiliation":[{"name":"Colorado Perinatal Care Quality Collaborative  Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0012-1473","authenticated-orcid":false,"given":"A.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Colorado Perinatal Care Quality Collaborative  Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,11]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Colorado Maternal Mortality Review Committee (MMRC) \u201cMaternal Mortality in Colorado 2016\u20102020 \u201d(2023) Colorado Department of Public Health and Environment (CDPHE) https:\/\/drive.google.com\/file\/d\/1L8YyFzO7MUKJuG17p2qa1O8mwTz_PR4T\/view."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.24991"},{"key":"e_1_2_9_3_2","doi-asserted-by":"crossref","unstructured":"Erratum in:Journal of the American Medical Association. 2021 325 no. 22:2316 https:\/\/doi.org\/10.1001\/jama.2021.8098.","DOI":"10.1001\/jama.2021.8098"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2021.1975866"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0192513X15581659"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.2147\/SAR.S319180"},{"key":"e_1_2_9_7_1","unstructured":"Colorado Center for Nursing Excellence \u201cColorado's Nursing Workforce A Survey of Employers \u201d(2017) https:\/\/www.coloradonursingcenter.org\/documents\/Nursing_workforce_survey_05162017.pdf."},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1747\u2010597X\u20105\u201021"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","unstructured":"K. S.SwensonandK.Breen \u201cReducing Stigma and Bias in Perinatal Substance Use Care: A Training for Obstetric and Neonatal Providers \u201d(2025) medRxiv 2025.06.17.25329801 https:\/\/doi.org\/10.1101\/2025.06.17.25329801.","DOI":"10.1101\/2025.06.17.25329801"},{"key":"e_1_2_9_10_1","unstructured":"L.RadelandE.Madden \u201cFreeing Children for Adoption within the Adoption and Safe Families Act Timeline \u201d(2021) Office of the Assistant Secretary for Planning and Evaluation U.S. Department of Health and Human Services https:\/\/aspe.hhs.gov\/sites\/default\/files\/private\/pdf\/265036\/freeing\u2010children\u2010for\u2010adoption\u2010asfa\u2010pt\u20101.pdf."},{"key":"e_1_2_9_11_1","unstructured":"Colorado 2025\u20132029 Child and Family Service Plan \u201cColorado Office of Children Youth & Families \u201d(2024) https:\/\/coloradocwts.com\/wp\u2010content\/uploads\/2024\/09\/Colorado\u20102025\u20102029\u2010CFSP_August\u2010Resubmission.pdf."},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102018\u2010025741"},{"key":"e_1_2_9_13_1","unstructured":"M.Raz \u201cWhy Mandatory Reporting Doesn't Keep Children Safe \u201d(2024) Time https:\/\/time.com\/6589854\/mandatory\u2010reporting\u2010child\u2010abuse\u2010prevention\/."},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/10443894241310081"}],"container-title":["Birth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.70123","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/birt.70123","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.70123","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T04:26:40Z","timestamp":1791779200000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/birt.70123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,11]]},"references-count":14,"alternative-id":["10.1111\/birt.70123"],"URL":"https:\/\/doi.org\/10.1111\/birt.70123","archive":["Portico"],"relation":{},"ISSN":["0730-7659","1523-536X"],"issn-type":[{"value":"0730-7659","type":"print"},{"value":"1523-536X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,11]]},"assertion":[{"value":"2024-11-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"birt.70123"}}