“They Gave Me Life”: Motherhood and Recovery in a Tribal Community

ABSTRACT

Objective: This study explored factors related to substance misuse and recovery among Native mothers in a Pacific Northwest tribe, focusing on motherhood as a motivating factor in seeking treatment and sustaining recovery. Method: Using a community-based participatory research approach, we conducted a thematic analysis of 20 in-depth interviews and one focus group (N = 12) with Native women 18 years and older living on or near the reservation. Results: Qualitative findings highlighted challenges, motivations and strategies for seeking treatment and recovery in four major themes: (a) the close relationship between interpersonal violence and substance misuse; (b) traditional healing in recovery; (c) community-specific challenges to recovery; and (d) the motivating role of motherhood in seeking treatment and successful recovery. Conclusions: A central finding of this work is that pregnancy and motherhood may be underexplored factors in Native women's substance use. Results support previous work suggesting that Native women are at high risk of interpersonal trauma and that trauma contributes to substance misuse. Findings offer several rich implications for treatment and recovery among Native mothers in tribal communities including the necessity of trauma-informed treatment, community and culturally-based interventions, more integration of treatment services with Child Protective Services, and drawing on motherhood as a motivation for seeking and succeeding in recovery.

KEYWORDS:

• American Indian
• maternal health
• substance use
• trauma
• child protective services

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Acknowledgments

We would like to acknowledge the Community Advisory Board, Publications Committee, project staff, and tribal members whose commitment to this work undoubtedly contributed to its success. Research reported in this publication was supported in part by the National Institute on Drug Abuse of the National Institutes of Health under award numbers R01DA029001 (Evans-Campbell, PI) and HHSN271201200663P, by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under award number P60MD006909, and by the National Institute of Mental Health of the National Institutes of Health under award number T32MH019960. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

No commercial relationship existed in the form of financial support or personal financial interest for this work.

Notes

1 In-depth interview.

2 Historical trauma can be conceptualized as an event or set of events perpetrated on a group of people or their environment who share a specific group identity (e.g., tribal affiliation) that cause catastrophic upheaval such as the annihilation or disruption to traditional lifeways, culture, and identity (Evans-Campbell, 2008; Walters, Beltran, Huh, & Evans-Campbell, 2011). The forced or coerced removal of Native children to boarding schools is considered a historically traumatic event, as well as a major and prolonged adverse event for each child.

3 The upper age range for child-bearing age followed standards set by the National Survey on Family Growth, a national survey of individuals up to 44 years of age to gather information on pregnancy, infertility, use of contraception, and general and reproductive health (https://www.cdc.gov/nchs/nsfg/about_nsfg.htm).

4 In-depth interview.

Additional information

Funding

National Institute on Minority Health and Health Disparitiess (P60MD006909). National Institute on Drug Abuse (HHSN271201200663P, R01DA029001). National Institute of Mental Health (T32MH019960).