The overall analysis of patients’ responses to interview and focus group questions about their experiences with perinatal substance use treatment; any obstacles or barriers; what they appreciated or found difficult about the program; their birth/delivery experiences (if the interview was conducted postpartum); and anything else they wanted to tell the authors revealed overall themes from the larger study that are presented elsewhere [10]. Among these, many participants in the comprehensive perinatal substance use treatment program – 11 of 27 – mentioned specific concerns about outside agencies’ involvement in their pregnancies and parenting resulting from their substance use. This theme from the larger study is the focus of the subset analysis presented here. Re-examining interview and focus group transcripts, and participant-observation fieldnotes from all participants (not just those who mentioned Social Services Involvement), the first two authors designed a subset analysis to more closely evaluate how patients’ perceptions of Social Services (child protective services) seemed to influence their feelings about engagement with perinatal substance use treatment. Theoretical findings were then discussed with other authors to negotiate a full analysis of findings with the full team of authors, including clinical providers who see perinatal patients with OUD diagnoses. We particularly sought to interpret subthemes about patients’ fears of Social Services involvement and the clinical implications of these for access to perinatal substance use treatment.

The subset analysis research design allowed for triangulation of key themes and concepts across several data sources: interview and focus group data, and participant-observation fieldnotes. Cross-comparisons of analysis between various data sources confirmed shared experiences, key points of agreement, and any points of departure.

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