Federal legislation mandates healthcare providers to notify child protective service (CPS) agencies and offer a voluntary care plan called a “plan of safe care” (POSC) for all infants born affected by prenatal substance use. While POSCs aim to provide supportive services for families impacted by substance use, little is known about birth parents' perceptions and experiences. To examine birth parents' perceptions and experiences regarding POSC. Parents offered a POSC in Philadelphia in the prior year were included. This is a qualitative interview study. Participants were recruited from birth hospitals and community-based programs with telephone consent and interview procedures. Transcripts were analyzed using an inductive, grounded theory approach to identify content themes. Twelve birth parents were interviewed (30.7 % of eligible, contacted individuals). Fear of CPS involvement and stigma were common. Some birth parents reported that the increased scrutiny related to POSCs negatively impacted their attitudes toward healthcare providers and medications for opioid use disorder (MOUD). While parents found the consolidated resource information helpful, many did not know how to access services. Finally, parents desired more individualized plans tailored to their unique family needs. Stigma, confusion, and fear of CPS involvement undermine the goal of POSCs to support substance-exposed infants and birth parents. Providers serving this population should be transparent regarding CPS notifications, provide compassionate, non-stigmatizing care, and offer coordination services to support engagement after discharge. Policymakers should consider separating POSCs from CPS to avoid exacerbating fear and mistrust.

中文翻译：

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“他们不仅可以带走我的孩子，还可以给我一个机会”：受围产期物质使用影响的亲生父母的安全护理计划的经验

联邦立法要求医疗保健提供者通知儿童保护服务 (CPS) 机构，并为所有受产前药物使用影响的婴儿提供一项名为“安全护理计划”(POSC) 的自愿护理计划。尽管 POSC 旨在为受药物使用影响的家庭提供支持服务，但人们对亲生父母的看法和经历知之甚少。调查亲生父母对 POSC 的看法和经历。去年在费城参加过 POSC 的家长也包括在内。这是一项定性访谈研究。参与者是通过电话同意和访谈程序从分娩医院和社区项目中招募的。使用归纳、扎根的理论方法对成绩单进行分析，以确定内容主题。 12 名亲生父母接受了采访（符合条件的联系个人的 30.7%）。对 CPS 参与和耻辱的恐惧很常见。一些亲生父母报告说，与 POSC 相关的日益严格的审查对他们对医疗保健提供者和阿片类药物使用障碍 (MOUD) 药物的态度产生了负面影响。虽然家长们发现整合的资源信息很有帮助，但许多人不知道如何获得服务。最后，父母希望针对他们独特的家庭需求制定更个性化的计划。对 CPS 参与的耻辱、困惑和恐惧破坏了 POSC 支持物质暴露婴儿和亲生父母的目标。为这一人群提供服务的提供者应在 CPS 通知方面保持透明，提供富有同情心、非侮辱性的护理，并提供协调服务以支持出院后的参与。政策制定者应考虑将 POSC 与 CPS 分开，以避免加剧恐惧和不信任。