Integrated care for perinatal opioid use in rural and northern Canada: an integrative review

Abstract

Although perinatal opioid use is relatively rare, geographic disparities in prevalence exist in Canada. The maternal and infant health risks are exacerbated by social determinants of health (SDH) such as poverty, trauma, and healthcare access. Integrated care (IC) models, which coordinate health and social services, offer promise but remain underexplored in rural perinatal contexts. This integrative review assesses how IC models address SDH and influence access to care for pregnant individuals using opioids in rural settings. Using Whittemore and Knafl’s methodology, a systematic search identified 23 articles covering 10 IC programs. Eight themes emerged, including scope of care; culturally grounded models; SDH in rural and northern communities; intersectionality; mitigating SDH; rural–urban differences; health and social outcomes; and barriers and enablers to integrated service delivery. Findings and recommendations may inform trauma-informed, equity-focused IC models that address intersecting SDH and improve maternal–infant outcomes in marginalized communities.