In this newly published brief, two Camden Coalition care team members – Michelle Adyniec, RN, BSN and Jessica Cordero, MA, CHW — share their lessons learned from Camden Delivers,our maternal health care management pilot that worked with pregnant people who have a substance use disorder (SUD). We are so grateful that the forward to this piece was penned by Christine Beyer, Commissioner, New Jersey Department of Children and Families.

For people with substance use disorders (SUDs), pregnancy and early parenthood can make an already difficult struggle even more complex. Pregnancy can mean dealing with new or exacerbated chronic health conditions, significant financial strain, increased risk of domestic violence and abuse, and interaction with a host of new medical and social services. And chronic illness, including substance use disorders, can increase the risk of maternal and infant mortality.

We launched Camden Delivers in the fall of 2017 to better understand the experience and needs of pregnant people who have SUDs and are at risk for maternal mortality and other adverse maternal health outcomes. Maternal mortality in the U.S. has more than doubled in the last ten years; NJ ranks 35th in the nation in terms of pregnancy-related deaths. In communities of color these rates are even higher. In Camden, NJ, for every 100,000 women, over 30 women die in childbirth, one of the highest maternal mortality rates in the country. What we quickly learned as we began working with pregnant women and new mothers in Camden was that even more than their substance use or physical health conditions, the major barrier to wellness for participants was their involvement in the child welfare and court systems.

This brief outlines five lessons learned through this pilot and our key recommendations for how to better support pregnant and post-partum people who also have complex health and social needs and are involved with health systems, child welfare, the courts and other social services.