Perinatal Opioid-Related Disorder Care Across Nursing and Community Settings

Abstract

Abstract Background: Pregnant and postpartum individuals affected by opioid use disorder (OUD) experience barriers to accessing medications for opioid use disorder (MOUD) and engagement in treatment. Nursing-led approaches that integrate community and pharmacy may help close care gaps, especially in rural areas. Methods: This scoping review examined current U.S.-based evidence describing certified nurse midwives (CNMs), community-based pharmacists (CBPs), and community health support (CHS) in caring for perinatal OUD. Using PRISMA-ScR guidelines, four databases were searched for English-language studies published between 2015 and 2025, reflecting the U.S. policy and practice context for MOUD delivery. The 2015 start date reflects contemporary policy changes expanding access to MOUD. Data were charted and summarized. Results: Fifteen studies met inclusion criteria. CNMs and nurses were trusted clinicians who advanced MOUD initiation and retention through stigma reduction and relational care. Limited pharmacy evidence showed potential to expand MOUD access but found insurance and stigma barriers. CHS served as trusted navigators, improving engagement, mental health, and continuity of care. Clinical Implications: Collaborative CNM–CBP–CHS models may enhance access and retention in perinatal OUD care. Nursing leadership, education, and community partnerships are needed to advance care for perinatal OUD. Supplemental Digital Content is available in the text