Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Sarah H. Heil


Introduction: People with opioid use disorder (OUD) have greater disparities in access to sexual and reproductive health (SRH) services and are at greater risk for adverse SRH outcomes. Preconception health (i.e., health prior to pregnancy) has a significant impact on perinatal outcomes. The present study had two aims: first, to characterize preconception health knowledge among female and male patients receiving medication treatment for OUD (MOUD) compared to those receiving primary care (PC) services; and second, to evaluate provider beliefs about preconception health priorities for patients with OUD.

Methods: For Aim 1, participants were convenience samples of MOUD and PC patients, all between 18-45 years old. Knowledge was assessed with the validated Preconception Health Knowledge Questionnaire (PHKQ), a self-administered, 25-question multiple-choice test. For Aim 2, healthcare providers with experience providing obstetrical/maternal care for pregnant individuals with OUD were purposively selected. Providers were asked to rank a list of preconception heath areas for individuals with OUD and then interviewed to discuss their rankings.

Results: Among survey participants (n=202), the average percent correct on the PHKQ was 49.4%. MOUD participants had significantly lower scores than PC participants (means: 42.5% vs. 56.3%, respectively). Male participants had significantly lower scores than female participants (means: 46.0% vs. 52.8%, respectively). Among interview participants (n=9), areas of preconception health ranked as top priorities for individuals with OUD included “alcohol, nicotine, and illegal drug use,” “use of teratogenic medications,” “pregnancy intention and timing,” “medical conditions,” and “intimate partner violence.”

Conclusions: Individuals with OUD have notable deficits in their knowledge about preconception health. Although MOUD participants had lower scores than PC participants and male participants had lower scores than female participants, all individuals would benefit from increasing their knowledge. Individuals with OUD may encounter additional barriers to accessing preconception healthcare. These data contribute important information for designing an intervention that will provide comprehensive care built on a foundation of reproductive justice and that acknowledges the multiple complex issues that this population faces when pregnant or parenting.



Number of Pages

65 p.

Available for download on Saturday, April 18, 2026