Due to widespread punitive drug and child welfare policies, pregnant or parenting people who use drugs are less likely to access prenatal and postnatal care. When they do, they encounter unique forms of stigma, discrimination, and legal challenges across all systems of care.

Pregnant and parenting people who use drugs can face severe legal repercussions, including the involvement of Child Protective Services, which too often results in family separation. In New Jersey, approximately one-third of children entering foster care are there in part because of parental substance use. Tragically, when separated from their children, parents are at an increased risk of experiencing a fatal overdose. Family separation also has harmful impacts on children who are placed into foster system services — particularly Black, Native American, multiracial, and Pacific Islander children who are overrepresented in the foster care system.

To support children and families, there is urgent need for healthcare workers to adopt a family-focused, whole-person approach when working with pregnant and parenting people who use drugs. Access to quality maternal healthcare and social support without the fear of criminalization is crucial, not only for racial and health equity but also for overdose prevention. Overdose is a leading cause of maternal mortality in the United States. The good news is that harm reduction strategies centering the health, autonomy, and dignity of pregnant and parenting people who use drugs improve maternal health outcomes.

“Creating safe care: Supporting pregnant and parenting patients who use drugs,” a toolkit created by the Camden Coalition with support from Vital Strategies, equips healthcare providers with the knowledge and tools they need to support pregnant and parenting people who use drugs. It aims to render reports made to child welfare services a last resort only.

Designed for healthcare workers, the toolkit is informed by the practices and experiences of providers and experts serving this population. It highlights the health and social needs of pregnant and parenting people who use drugs and offers strategies to address those needs grounded in racial equity, compassion, and harm reduction principles. The toolkit is meant to serve as a guide for implementing best practices and evidence-based practice models in caring for pregnant and parenting patients.

The toolkit is organized into five main sections:

• Relationship-building
• Screening
• Treatment planning
• Reporting
• Providers as partners

Each intervention in the toolkit is trauma-informed and evidence-based. Worksheets, tools, and sample forms that can be easily replicated and utilized in care settings are included so healthcare workers can better support pregnant and parenting people in their practice. Templates for family court letters, motivational interviewing scripts, and health screening tools are just a few of the additional resources offered.

“Creating safe care,” which seeks to expand support for pregnant and parenting people, comes at a crucial time as reproductive rights are being rolled back in the United States. On June 24, the U.S. Supreme Court overturned Roe v. Wade, a landmark 1973 ruling affirming the constitutional right to abortion. The overturning of Roe v. Wade disproportionately impacts Black, Indigenous, and other people of color seeking an abortion, amplifying barriers such as out-of-state travel costs and systemic racism in healthcare. Many experts worry that state-level abortion bans and “fetal personhood” measures will create even more severe potential legal repercussions for pregnant individuals who use drugs.

Vital Strategies and the Camden Coalition will be co-hosting “Exploring tools to support pregnant and parenting patients who use drugs,” a moderated panel discussion on August 4, 2022 at 1 pm ET to highlight the toolkit and evidence-based strategies that healthcare providers can utilize to preserve and strengthen families. The webinar will also address ways in which providers can respond to harmful federal and state policies, and steps they can take to improve policies and practices within their own institutions.

To learn more about the guide and our work, register for the August 4 webinar here.

Learn more about Vital Strategies’ Overdose Prevention Program and follow them on Twitter at @VitalStrat.