Avoiding Serious Outcomes During the Pandemic and Beyond
Substance use during pregnancy and the postpartum period has significant negative outcomes for the mother and her infant including low birth weights, developmental delays, neonatal abstinence syndrome, placental abruption, and maternal death. For women with opioid addiction, mortality has increased ten-fold over the past ten years leading to a public health crisis. Furthermore, the pandemic has decreased the likelihood of pregnant and postpartum mothers receiving treatment while increasing the risk of overdose and death.
Clinicians caring for perinatal women are in a unique position to address patient substance misuse and advocate for intervention and treatment. Pregnancy can be a window of opportunity to provide anticipatory guidance on abstinence from substance use, and to provide screening during and after pregnancy, interventions for enhancing wellness and resilience, and referral for treatment. Assisting patients with substance use issues requires a team approach as it is common for women with substance abuse issues to have comorbid mental health issues. Women with both disorders have more severe clinical symptoms, more social issues, and legal problems.
Here are interventions clinicians can do to prevent bad outcomes.
Screen for perinatal opioid use in all pregnant and postpartum mothers
Use motivational interviewing to help perinatal women reduce and stop use
Refer for substance use treatment
If referral is refused, refer for mental health evaluation to decrease stress
Ensure mothers receive adequate post-birth care including substance misuse treatment and opioid relapse prevention programs
- Illinois DocAssist consultants are available to assist providers in caring for perinatal women with substance use issues. Visit the Illinois DocAssist website for more information including screening tools, intervention strategies and treatment resources for perinatal women.
- Our website also offers a free educational webinar with Illinois DocAssist Medical Director, Diane Misch, MD on perinatal substance use.