Breaking Down Barriers: How Innovative Training is Transforming Perinatal Care for Moms Facing Substance Use Disorder
For too long, women struggling with substance use disorder have faced judgment and inadequate care during one of the most vulnerable times in their lives – pregnancy and childbirth. Now, a groundbreaking training program developed at CU Anschutz, in partnership with the Colorado Perinatal Care Quality Collaborative (CPCQC), is changing the narrative by tackling provider bias and fostering a more empathetic approach to care.
The Hidden Crisis: Stigma and Maternal Overdose
Maternal deaths due to overdose have tripled in the United States since 2018, with accidental overdose remaining the second leading cause of death among pregnant and postpartum women in Colorado. These stark statistics underscore the urgent demand for a shift in how healthcare providers approach perinatal substance use.
The problem isn’t simply the substance use itself, but the layers of trauma, lack of access to healthcare, and fear of repercussions – including involvement from Child Protective Services – that often drive women to conceal their struggles. This concealment hinders their ability to receive the support they desperately need.
A New Approach: Lived Experience as a Catalyst for Change
Karli Swenson, PhD, MPH, a postdoctoral fellow at CU Anschutz, spearheaded the development of a virtual training program designed to address these issues. Recognizing that traditional approaches often fell short, Swenson collaborated with peer recovery specialist Racquel Garcia of HardBeauty, an organization specializing in lived-experience expertise.
The core of the training centers on stories shared by women in recovery who now serve as perinatal peer support advocates. These narratives offer a powerful window into the experiences that lead to substance use, the challenges of navigating pregnancy and motherhood in recovery, and the importance of compassionate care.
“We created a program for people who did not want to be there,” explained Swenson. “Racquel warned me that talks on perinatal substance use weren’t ‘bright and shiny’ – and what we’ve put together is real, raw and painful.”
Impact and Results: Reducing Bias, Building Bridges
Early results from the training are promising. A pre-post intervention study demonstrated statistically significant improvements in provider response scores, indicating a reduction in stigma and bias. Qualitative feedback further highlighted the training’s relevance and impact.
The training doesn’t shy away from difficult conversations. Participants are encouraged to share their own feelings – ranging from anger and regret to hopelessness – and to ask challenging questions. A 10-step toolkit provides practical guidance on empathetic communication, naloxone administration, and connecting patients with vital resources.
More than 1,500 providers have already completed the training, and the ripple effects are being felt in labor and delivery units and NICUs across Colorado.
Future Trends: Expanding Access and Integrating Peer Support
The success of this program points to several key trends that are likely to shape the future of perinatal substance use care:
- Wider Adoption of Lived-Experience Training: Expect to witness more healthcare systems incorporating training models that prioritize the voices and experiences of individuals with lived experience of substance use disorder.
- Increased Integration of Peer Support: The role of peer support advocates will become increasingly central to providing holistic and trauma-informed care. These advocates can offer invaluable support, mentorship, and connection to resources.
- Telehealth Expansion: Telehealth platforms can expand access to specialized care for women in rural or underserved areas, overcoming geographical barriers to treatment.
- Policy Changes: Continued advocacy for policies that reduce barriers to treatment, protect pregnant women from criminalization, and promote access to medication-assisted treatment will be crucial.
- Focus on Prevention: Addressing the root causes of substance use – such as trauma, poverty, and lack of access to mental healthcare – will be essential for preventing substance use disorder in the first place.
Did you know? A recent change in Colorado law now allows obstetricians to legally start their patients on medication for opioid use disorder, a critical step in expanding access to evidence-based treatment.
Addressing Systemic Barriers: A Multifaceted Approach
Reducing stigma and improving outcomes for pregnant women with substance use disorder requires a multifaceted approach that addresses systemic barriers at all levels. This includes training healthcare providers, expanding access to treatment and support services, and advocating for policies that promote compassion and understanding.
As Karli Swenson emphasizes, “The truth is, we all have internal stigma and biases. Even those of us who work in this field. We just need to acknowledge it so One can work on it.”
FAQ
Q: What is perinatal substance use disorder?
A: This refers to substance use during pregnancy and the postpartum period.
Q: Why is stigma a problem in perinatal care?
A: Stigma prevents women from seeking facilitate, leads to poor treatment, and hinders access to evidence-based care.
Q: What is peer support?
A: Peer support involves individuals with lived experience of substance use disorder providing support, mentorship, and advocacy to others.
Q: Where can I find more information about perinatal substance use disorder?
A: Visit the Reducing Stigma and Bias in Perinatal Substance Use Care resource.
Pro Tip: If you are a healthcare provider, consider seeking out training opportunities focused on trauma-informed care and implicit bias reduction.
Have you experienced or witnessed the impact of stigma in perinatal care? Share your thoughts in the comments below.
