Barriers to Receiving Substance Abuse Treatment Among Rural Pregnant Women in Kentucky

Research presenting outcomes for women who enter substance abuse treatment during pregnancy consistently shows benefits. While
treatment has nearly universal benefits, there are many barriers to seeking substance abuse treatment for pregnant women.
The purpose of this study is to explore barriers for rural pregnant women seeking substance abuse treatment. There were three
eligibility criteria for study participation: (1) aged 18 and older, (2) pregnant, and (3) undergoing short-term inpatient
detoxification at the University of Kentucky Chandler Medical Center. Eighty-five rural women (N = 85) were included in the
analysis. Substance use history and previous treatment were assessed with measures adapted from the Addiction Severity Index.
Treatment barriers were measured with three qualitative questions and were coded into four overarching categories: availability,
accessibility, affordability, and acceptability barriers. This sample had an extensive substance use history. Almost all participants
had used alcohol (98%), marijuana (98%), illicit opiates (99%), and cigarettes (97%). On average, participants reported about
two barriers to receiving treatment (Mean = 1.8; SD = 1.3), with over 80% of the sample reporting having experienced any barrier
to treatment. The majority experienced acceptability (51%) and accessibility (49%) barriers. Twenty-six percent (26%) of the
sample reported availability barriers. A smaller percentage of participants reported affordability barriers (13%). Rural pregnant
women seeking substance abuse treatment face many obstacles to receiving needed treatment. More studies on barriers to substance
abuse treatment among rural pregnant women are needed. Identifying these barriers can help in improving treatment access and
services.