Expand Perinatal Treatment and Support for People with SUDs

Introductory Paragraph

Most doctors recommend that pregnant women undergo a long-term treatment plan called drug-assisted stabilization using methadone, also known as harm reduction therapy. This treatment remains sustainable for a woman after she has given birth, because it's covered under Medicaid, so new mothers can still access the treatment, even after their six-week Medicaid-provided postnatal care is done. The treatment also doesn't subject a woman's mind and body through the stress of full withdrawal, allowing her to focus on caring for herself and her baby.

It is extremely important for infants to be well-nourished and well-cared for in order for the baby to thrive. While this is critically important to both mother and baby, making healthy choices isn’t so clear-cut for some pregnant women. Those who become pregnant while facing a substance abuse disorder face great challenges in caring for their body and the baby they’re carrying. Substance abuse at any time, but especially during pregnancy, is a highly stigmatized issue and one that has only gotten worse over the decades . Substance abuse during pregnancy can have detrimental health effects on the baby and the mother, but the stigma may prevent the mother from seeking prenatal and substance abuse treatment .

Promising Practices

Perinatal Addiction Treatment Program

Perinatal Addiction Treatment Program- Dartmouth Hitchcock Medical Center
Program Highlights

• Integrated Care Model: Includes maternity care, substance use treatment, behavioral health/psychiatry, pediatrics
• Participant Drive Design
• Private setting 10 minutes from hospital campus
• Tablet-based SBIRT screening
• 18 week parenting class

Outcome Successes

• Perinatal: Average gestational age is over 38 weeks; Average birthweight in the normal range
• Decreased NAS treatment rate
• Decreased neonatal LOS
• Effective use of technology for screening
• 2/3 of participants remain in treatment postpartum

Centering Pregnancy

While not specifically focusing on issues of addiction or substance misuse among pregnant women, the Centering Pregnancy approach has the potential to cost-effectively improve prenatal and perinatal care among women who may be using or be addicted to opioids or other substances. It is a group approach to prenatal and perinatal care.