Juggling Competing Responsibilities: Experiences with Parenting, Child Welfare, and Substance Use Treatment during the COVID-19 Pandemic

The COVID-19 pandemic posed substantial challenges to all parents and families with children. However, women with substance use disorder (SUD) raising young children were particularly burdened, primarily stemming from their responsibilities and challenges concerning family and parenting, child welfare involvement, and substance use recovery. This qualitative study sought to elucidate the complex intersection among parenting, child welfare, and substance use treatment for pregnant and postpartum women raising young children during the pandemic. Participants were 35 women enrolled in a clinical trial of a therapeutic parenting intervention within a prenatal clinic for people with SUD. They were interviewed remotely using a semi-structured Coronavirus Pandemic Qualitative Interview protocol developed for the study. Following a thematic analysis approach, two coders analyzed transcribed interviews through line-by-line coding using NVivo 12. Findings revealed that participants encountered both similar and distinct challenges compared to the general population of families with young children during the pandemic. Like other families, they expressed struggles with typical life tasks and concerns over children’s health and development. Distinct to families managing substance use recovery, they described adverse interactions with the child welfare system, conflicting feelings about changes in substance use treatment, and positivity amidst uncertainty. Findings provide insight into the difficulties faced by families involved in the child welfare system managing parental SUD and recovery. Furthermore, they highlight the need to address more effectively the often-hidden struggles faced by this population through specialized interventions and greater collaborations among various services.