Postpartum women’s motivation for substance use recovery: an exploratory qualitative study of recovery capital

Abstract Background Canada is facing a national opioid crisis, with an average of 20 opioid-related deaths reported daily. Postpartum women who use non-prescription opioids and unregulated substances are at high risk of relapse and overdose. They also face significant health and social challenges that create barriers to successful, long-term recovery. While many women reduce or stop substance use during pregnancy, sustained recovery in the postpartum period remains a challenge. Despite this, little research has explored the personal, social, and structural factors, collectively conceptualized as recovery capital, that sustain motivation for recovery after birth. Therefore, the purpose of this study was to explore the factors that influence motivation for recovery among postpartum women with a history of substance use, with particular attention to the personal, social, and structural dimensions of recovery capital. Methods An exploratory qualitative design was used to capture the experiences of 16 postpartum women in Saskatchewan, Canada, who had given birth within the previous two years and were in recovery from non-prescription opioid or unregulated substance use for at least three months. Participants were recruited through public health and treatment agencies. Semi-structured interviews were conducted in-person or by phone and analyzed using Braun and Clarke’s six-phase thematic analysis. Results The sample (N = 16) was primarily Indigenous (n = 14), predominantly in their twenties, and single (n = 14), with most participants having a high school education or less, low household income, and limited employment. Thematic analysis identified four themes: (1) the impact of limited accessibility on recovery, (2) parenthood as a motivator, (3) the role of peer, family, and professional support systems, and (4) the transformative power of resilience. Conclusions Postpartum women with substance use disorders are highly motivated to recover, often driven by their roles as mothers. However, motivation alone is not enough without adequate recovery capital, including access to integrated, trauma-informed, and culturally safe treatment, social supports, and structural resources. Findings highlight the importance of expanding substance use programs that address structural barriers, promote resilience, and include peer, family, and professional supports. Comprehensive, strength-based treatment models are critical to sustaining and supporting long-term recovery for postpartum women.