Table 2.

Participant quotations

Theme 1	Quote 2	“They put my name on a registry of child abusers all for taking a medication that I wasn't allowed to get off of.” (Participant 4, 31-year-old white mother)
	Quote 3	“I definitely think that if … you have either done something in your history of parenthood to show that you are not fit to be a parent, or to show that you are not safe, or that you put your child in harm’s way … that warrants an investigation, or a case … In our situation, again, I’m not trying to sound boastful, but I literally did every single thing right from the second that I found out I was pregnant.” (Participant 12, 26-year-old white mother)
	Quote 4	“Yeah, both of the hospitals and [CPS] were aware that my husband was on the same treatment that I was on. Nobody filed … against him, right. Why? We’re both parenting here, right. Why is it? Why are they not filing … against men that are on [MOUD] and have newborns, right? It’s only against women, and I feel like that’s also gender discrimination too, right. We’re doing the same thing … it’s abuse and neglect for me to take something to treat my addiction. Yet it’s not for him.” (Participant 13, 40-year-old white mother)
Theme 2	Quote 6	“I was so scared. I had everything prepared for the baby… He had everything he needed. I wasn’t scared on that aspect, but I knew that [CPS] was gonna be involved. Having [CPS] involved is a scary situation. One of your children gets taken away from [CPS], you think the littlest thing that you do, they can go and take away your son.” (Participant 5, 27-year-old Latina mixed-race mother)
	Quote 8	“[My health care providers] agreed to let me stay on the [buprenorphine] during pregnancy. My entire pregnancy I was told that [CPS] would come do a brief investigation and then they would leave. That was not what happened to me. They opened the case on me … there was no reason for them to have gotten involved… How I’ve been treated because of being on [buprenorphine], having a child is absolutely horrifying.” (Participant 4, 31-year-old white mother)
	Quote 9	“I wanted to keep that stage or part of my family private … I was completely exposed to my whole entire family ‘cause [CPS] wanted a safety plan. I don’t have many friends over here in Boston … In that case, I was forced to include my family for my family to know what was going on.” (Participant 14, 40-year-old Latina mother)
	Quote 10	“Just the fact that some strange guy is showing up saying that he wants to meet with my son. I just thought it was really inappropriate … I don’t know what they expected from my four-year-old. Did he think that [my son] was gonna say, “Mommy and Daddy smoke crack” or whatever? I don’t know what his expectation was, but he interviewed my son.” (Participant 13, 40-year-old white mother)
Theme 3	Quote 15	“[The social worker] was like, ‘Well, before you leave, remember, you’re gonna have [CPS] in your life and they’re gonna [file a report]. You might wanna tell me what your plan is before you leave here’ cause I will have to document that you had no plan and [were] pregnant.’ … so… so I just stayed.” (Participant 21, 31-year-old Black mixed-race mother)
	Quote 16	“They would make comments like that like, ‘Wow, that’s really high. Are you ever thinking about going down? What’s your plans for after?’ … they’re always like, ‘Okay, what dose are you on?’ Then I feel like they’re almost expecting me to be going down. That’s the impression that I got.” (Participant 25, 35-year-old white mother)
	Quote 18	“That trickle-down effect goes to [CPS]. That’s how much it trickles down, that [CPS] is now gonna be in more than what it was when I was able to stay on the clinic. Now I have to explain myself to [CPS], all because [the methadone clinic] didn’t wanna follow the rules that the governor put in place, and I just asked them to do that. I just asked them to not put anybody near me when I’m dosing. How hard is that?” (Participant 15, 31-year-old Black mother)