The qualitative data used for this project had a few limitations that impact the generalizability of this study. All interviews took place over Zoom, which can create barriers to connection and building rapport. Despite statewide recruitment efforts, most interview participants were from Tulsa. Future studies that focus on recruitment from rural areas, especially counties where criminalization is more common, would improve our understanding of how those impacted by geographic disparities in obstetric and substance use treatment care navigate health systems.

Although some interview participants had been involved in the criminal justice system, none had faced charges directly related to perinatal substance use. Researchers gained insight on this facet of the issue through various methods (judicial documentation, court observation, subject matter expert interviews). However, interviews with those who have lived experience would provide greater detail on addressing concerns related to pregnancy criminalization.

Future research that wishes to expand upon this work should prioritize lived experience voices in rural areas and racial/ethnic diversity of participants. Additionally, to gain more generalizable knowledge on the topic, comparable research could and should be conducted in states with similar political conditions.