Jul 16, 2024 Stigma-Free Support for Moms

A new program helps pregnant women with substance use disorders get the care they need.

It’s a common scenario: A woman is pregnant but also has a substance use disorder that makes it difficult for her to quit using alcohol, tobacco, marijuana or other drugs during pregnancy. She may welcome help to overcome her disorder, yet she may also feel reluctant to speak openly about it.

To address such issues, collaboration with the Institute for Prevention and Recovery (IFPR) at RWJBarnabas Health (RWJBH) is helping obstetric providers learn how to recognize and respond to mothers with substance use disorders to ensure they get the treatment and referrals they need.

The initiative is important because substance use and substance use disorders during pregnancy are associated with adverse outcomes for moms and babies, and are the leading cause of pregnancy-associated deaths in the state, according to the most recent New Jersey Maternal Mortality report.

Yet pregnant and postpartum women still experience barriers to treatment for substance use disorders despite many positive changes, says Suzanne Spernal, Senior Vice President of Women’s Services at RWJBH, which delivers more babies than any other health care system in New Jersey. Spernal is also co-chair of the New Jersey Perinatal Quality Collaborative, a multiyear initiative funded by the Centers for Disease Control and Prevention.

“Providers want to support their patients but often feel they are not equipped with appropriate training and resources to address the complex and challenging needs of women and families impacted by addiction,” Spernal says.

In addition, stigma about substance use creates a significant barrier to care, especially for mothers. “A recent national study found that women are more likely to report stigma as a barrier to treatment compared with men,” Spernal notes.

Peer Recovery Specialists

One example of this multi-intervention initiative is the grant-funded maternal health program being offered at Robert Wood Johnson University Hospital in New Brunswick. The design of IFPR’s maternal health program builds in part on previous successes of peer-based support from recovery specialists who themselves are in long-term recovery from a substance use disorder. The new program employs maternal health recovery specialists who have also been trained as doulas.

The IFPR was awarded one of two nearly $1 million federal maternal health grants to address substance use issues during and after pregnancy with the goal of reducing related maternal deaths.

“We are bringing all of our experts together—including the voices of women with lived experience—to design a patient-centered, integrated care model that improves engagement and retention of pregnant and parenting women in substance use disorder treatment programs,” Spernal says. The new model ultimately promises to reduce stigma and barriers to care.“

The first step to decreasing mortality is for providers to recognize substance use disorder as a medical condition that can be treated in our own hospitals and offices,” says Alexis LaPietra, DO, Director of Addiction Medicine, RWJBH, and Medical Director of the IFPR. “This starts with education and empathy, which both directly address stigma.”

Encouraging Results

Spernal points to the recent success of a mom who was connected to IFPR’s services through the grant program at Robert Wood Johnson University Hospital in New Brunswick.

“The maternal health recovery specialist was able to build a trusting, stigma-free relationship with the patient, who utilized all of the services offered to her,” Spernal says. Resources included attending an All Recovery Meeting—a social support gathering facilitated by peer recovery specialists—designed specifically for mothers, called Moms Healing Together.

“When the patient experienced a crisis in her last trimester, the IFPR team responded and ensured that she was seen by familiar providers who knew her history,” Spernal says. “They advocated for her, and adjustments were made to her treatment plan using a shared decision-making approach so she could be safely discharged to home.

” After five months of program participation, she delivered a healthy baby boy. “This would not have been possible,” Spernal says, “without the peer-based support offered to this mom.”

Learn more about comprehensive maternal health services at RWJBarnabas Health.