Advisor(s)
Allison Shorten
Marti Rice
Committee Member(s)
Brian Brocato
Kathrine Dudding
Liang Shan
Natalia Ivankova
School
School of Nursing
Document Type
Dissertation
Department (new version)
Nursing
Date of Award
9-11-2025
Abstract
The opioid epidemic has dramatically increased the prevalence of maternal opioid use disorder (OUD) among women of reproductive age (12-45 years). Consequently, the incidence of prenatal opioid exposure and neonatal opioid withdrawal syndrome (NOWS) has significantly risen. Maternal OUD and NOWS pose significant challenges to maternal-infant bonding, potentially disrupting the transition to motherhood and delaying maternal role attainment (MRA). These disruptions can have profound and long-term consequences, including increased risks of abuse or neglect, sudden infant death syndrome, adverse neurodevelopmental outcomes, unplanned hospital readmissions, and even loss of custody. This dissertation aimed to enhance our understanding of MRA and mother-infant attachment in the early postpartum period for mothers with OUD who are the primary caregivers of infants with NOWS. To achieve this, we first refined the concept of maternal attachment specifically within the context of opioid-exposed mother-infant dyads. Subsequently, an integrative literature review was conducted to synthesize existing research, identify critical gaps in knowledge, develop a robust theoretical framework, and refine our research methodology. Employing a mixed methods approach, we measured MRA and mother-infant attachment while considering the perceived severity of NOWS symptoms. Simultaneously, we explored the lived experiences of these mothers through in-depth interviews to gain a nuanced understanding of their unique challenges and triumphs. Data analysis involved a sequential mixed-methods approach. Specifically, statistical analyses were conducted on the quantitative data to assess the relationships between perceived NOWS symptoms, MRA, and mother-infant attachment. Qualitative data gathered through one-on-one interviews were analyzed thematically to explore the lived experiences of mothers with OUD caring for infants with NOWS, providing richer context and more profound understanding to the quantitative findings. Finally, integrating quantitative and qualitative data through sequential design and analysis facilitated a more comprehensive understanding of the complex interplay between perceived NOWS symptoms, MRA, and mother-infant attachment. Our findings revealed that perceived NOWS symptoms may impact the development of MRA and the formation of secure mother-infant attachment in mothers with OUD.
ProQuest ID
Recommended Citation
Sanders, Allyson Nicole, "Exploring Maternal Role Attainment & Attachment For Mothers With Opioid Use Disorder Caring For Babies With Neonatal Opioid Withdrawal Syndrome" (2025). All ETDs from UAB. 7414.
https://digitalcommons.library.uab.edu/etd-collection/7414
