Hope amidst judgement: the meaning mothers accessing opioid treatment programmes ascribe to interactions with health services in the perinatal period

Six women were recruited through 'Methadone Clinics' in a metropolitan local health district in Sydney, Australia to examine how mothers accessing opioid treatment programmes in the perinatal period make meaning of their interactions with universal and targeted health services. Narrative inquiry informed data collection and analysis, with the two main themes of judgement and hope juxtaposed throughout the mothers' stories, and movement towards a change of identity from 'drug user' to 'good mother'. Fear of removal of their child by child protection services, self-judgement and judgement by health professionals as a 'bad mother' reduced interactions with services. This contrasted with increased mothering confidence and hope for a better future where staff were non-judgemental and supported the mothers in the care of their baby. Knowledge of the importance of the transition to motherhood, or motherhood again, for this group has implications for individual professional practice and services aiming to improve health outcomes.