Pregnant

This study looks at perinatal care for pregnant people with substance use disorders. Stigma and lack of access to treatment and recovery increases the risk for pregnant people. Results and suggestions from the study include the need to expand OUD treatment training, clarification on child welfare reporting rules, the need to include philanthropic investment, and more. 

The National Institute on Drug Abuse (NIDA) at the National Institutes of Health has reported that overdose mortality more than tripled for pregnant and postpartum women from 2018 to 2021. Findings from the study referenced by NIDA show that there are significant barriers which can obstruct care for this population living with substance use disorders.

The Substance Abuse and Mental Health Services Administration (SAMHSA) published Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and Their Infants in 2018. The National Center on Substance Abuse and Child Welfare (NCSACW) developed companion materials that offer information and strategies to support pregnant and parenting people with substance use disorders (SUDs) in the child welfare system.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has new resources available when supporting pregnant and parenting people with substance use disorders. Each resource supplements the SAMHSA Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and Their Infants publication.

Illuminate Colorado, an RCORP Neonatal Abstinence Syndrome (NAS) grantee, and partners presented on their Tough as a Mother campaign. Tough as a Mother is a statewide campaign launched in May 2020 and has been working to decrease the stigma around maternal substance use disorder. The Illuminate Colorado Team provided an overview of their campaign and how others can access the shared resources, followed by time for Q&A.

Investment in rural maternal care is a featured priority of the new all-of-government approach to high rates of maternal mortality across the United States.  The plan announced last week stresses more staff and capabilities for rural obstetrics and increased funding of the HRSA/FORHP-supported Rural Maternity and Obstetrics Management Strategies Program.  A 2019 study from the Rural Health Research Gateway found a greater number of potentially life-threatening complications with childbirth in rural areas.

We began with a critical examination of the history of family separation in the US to lay the groundwork for a discussion of both provider and patient trust and mistrust. The stigma and discrimination that pregnant, postpartum, and parenting people with substance use disorder was explored. We concluded with concrete suggestions to improve provider wellness, child development, and community cohesion.

Pre- Pregnancy fact sheet. Information for Providers 

Day 2: Wednesday, July 21, 2021

Maternal Treatment Approaches to Reduce NAS

This session will review evidence-based approaches available for rural providers to treat OUD in pregnancy and minimize NAS.

Marjorie Meyer, MD, Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, The University of Vermont

This guidance publication is intended to support the efforts of states, tribes, and local communities in addressing the needs of pregnant women with opioid use disorders and their infants and families. National data show that from 2000 to 2009 the use of opioids during pregnancy increased from 1.19 to 5.63 per 1,000 hospital births (Patrick, Schumacher, Benneyworth, Krans, McAllister, & Davis, 2012). Because of the high rate of opioid use and misuse among all women, including pregnant women, medical, social service, and judicial agencies are having to confront this concern more often and, in some communities, at alarming rates. This guidance document provides background information on the treatment of pregnant women with opioid use disorders, summarizes key aspects of guidelines that have been adopted by professional organizations across many of the disciplines, presents a comprehensive framework to organize these efforts in communities, and provides a collaborative practice guide for community planning to improve outcomes for these families. A set of appendices provides details on implementing the recommendations in the guide as well as a summary of lessons from one community’s experience over the past decade.