Opioid pain medication use during pregnancy is a growing concern in the United States. This study will explore the effects of a mindfulness-based intervention, Mindfulness-Oriented Recovery Enhancement (MORE), on opioid misuse, opioid craving, and parenting behavior among pregnant women using opioids. MORE has been found to decrease automatic attention to opioids, increase emotion regulation, and increase participants’ capacity to experience pleasure. In this study, we will conduct a randomized controlled trial of MORE with pregnant women who have been prescribed opioids. We will use cognitive tasks and psychophysiological measures (such as heart rate and galvanic skin response) to measure changes in attention to opioids and the ability to regulate emotion. We will also measure the effects of MORE versus a supportive visit control condition on quality of the mother-child relationship and parenting behaviors when the baby is five months old. Through my research and experiences working in community mental health, I have learned that substance-using pregnant women are often excluded from clinical trials despite the significant impact of substance use for mother and baby. This type of research is important for learning how to better support this important, underserved population.