We launched Camden Delivers in the fall of 2017 to better understand the experiences and needs of pregnant people who use drugs and are at risk for maternal mortality and other adverse maternal health outcomes.

Camden has one of the highest maternal mortality rates in the country: for every 100,000 women, over 30 women die in childbirth. Through Camden Delivers, we wanted to better understand the stories behind Camden’s maternal mortality statistics.

Camden Delivers was a targeted care-management intervention: potential participants were pregnant Camden city residents with a diagnosis of substance use disorder who had visited the ER or been admitted to the hospital at least once in the previous six months. As in our Camden Core Model, Camden Delivers participants worked closely with the community health workers, nurses, social workers, and attorneys on our care team to address the barriers that were preventing them from reaching their goals.

We found that for most women we worked with, their major barrier to wellness was the threat or reality of losing their children through involvement in the child welfare system. Therefore, along with coordinating referrals to behavioral health and social services, much of our care management centered around providing advocacy and support at child welfare team meetings and family court.

The Camden Delivers pilot helped us better understand how, in many cases, systems put in place to support our participants only added to the precarity and complexity of their lives. We used many of the lessons we learned in the development of Creating safe care, a toolkit designed to equip healthcare providers with the knowledge and tools they need to support pregnant and parenting people who use drugs, aiming to render reports made to child welfare services a last resort.