Mothering from the margins: lived experiences of incarcerated substance-abusing mothers and the developmental risks faced by their children in Sri Lanka

Abstract

Background: Children of incarcerated substance-abusing mothers represent a profoundly vulnerable yet under-researched population in low- and middle-income countries (LMICs). In Sri Lanka, the intersection of maternal addiction, incarceration and poverty poses complex threats to child health and development. This study explores the lived experiences of such mothers and the perceived risks their children face.

Methods: A qualitative, phenomenological study was conducted using 10 focus group discussions (FGDs) with 48 incarcerated mothers in Sri Lanka's largest female correctional facility. Participants were purposively sampled to ensure diversity in age, drug use history and caregiving experience. Data were collected through structured, audio-recorded FGDs conducted in Sinhala, transcribed, translated and thematically analysed using Braun and Clarke's framework. A second-order analysis was performed to interpret systemic drivers.

Results: Five major themes emerged: (1) barriers to healthcare access, (2) intergenerational substance use, (3) social stigma and marginalisation, (4) maternal guilt and psychological burden and (5) coping strategies and resilience. Many mothers described how stigma, fear of withdrawal and trauma hindered timely healthcare for themselves and their children. Substance use was often normalised in their families and workplaces, particularly in contexts of poverty, exploitation and domestic violence. Despite adversity, many participants expressed hope for recovery, supported by kinship networks, particularly maternal figures.

Conclusions: Substance use among incarcerated mothers in Sri Lanka is deeply entwined with structural violence, gendered labour exploitation and intergenerational trauma. Child health interventions must be trauma-informed, gender-responsive and family-centred, promoting rehabilitation while safeguarding child development.

Keywords: Caregivers; Child Health; Developing Countries; Health Policy; Qualitative research.

Figure 1. Structural and psychosocial drivers of maternal substance use and child vulnerability.