Engaging At-Risk Opioid Addicted Mothers Through Prenatal Care, Delivery, and Beyond
April 03, 2020
Breaking free from opioid addiction is a difficult and multifaceted challenge. For many women who are addicted, the process is made even more complex by pregnancy. Often these women are unable to tap into any kind of healthcare, whether for substance abuse treatment or prenatal treatment. The result is that they pursue neither, endangering two lives. That’s where the Giving Respect and Compassion to Expecting Moms, or G.R.A.C.E., program steps in. Created by the team at Lovelace Women’s Hospital in Albuquerque, NM, G.R.A.C.E. has been ground-breaking for a highly under-served population, says Dr. Abraham Lichtmacher, Chief of Women’s Services, who developed the program’s clinical protocols and support systems.
A Growing Population of Addicted Mothers
“Albuquerque and New Mexico are no different than a lot of other parts of the country in terms of the opioid epidemic hitting particularly hard,” Dr. Lichtmacher says. “And in Albuquerque we also have a huge number of stimulant methamphetamine users.”
The growing number of addicted expectant mothers, coupled with a lack of specific care deliverables, got Dr. Lichtmacher and some of his colleagues thinking about how to take the many maternal care services available at Lovelace and blend them with an outreach program. As other care professionals offered input, the idea of a comprehensive, wraparound program began to take shape.
Babies Going Through Withdrawal after Being Born
“We were seeing an increasing number of babies in our neonatal intensive care unit (NICU), not only from our local area, but also as referrals to us from around the state,” Dr. Lichtmacher says. “We were also seeing an increasing number of babies going through neonatal abstinence syndrome, where they’re actually going through active withdrawal the same way an adult would. We wanted to be proactive and take a more concerted, unified approach—that involves being able to identify these patients and potentially offer them treatment.”
It also made sense to consolidate the physical location and create an all-encompassing care situation for these women and their babies. Because as things stood, there might be treatment for addicted pregnant women in one part of the state, and a NICU capable of caring for their withdrawing newborns in another—meaning separation and another barrier to quality care.
A Multifaceted Program with One Overarching Goal
After much hard work over several months, G.R.A.C.E began seeing patients in early 2017, and by May of that year was fully operational and serving women addicted to opioids (both prescription and street-based), as well as those dealing with methamphetamines, cocaine, and alcohol. According to Lovelace officials, by mid-2019 the program had served 125 women and delivered roughly 70 babies with opioid withdrawal. (The hospital itself has a 53-bed Level III NICU alongside 16 labor and delivery rooms and a 41-bed mother/baby unit.)
G.R.A.C.E.’s services, which are available at three Lovelace Medical Group clinics across the city, include:
Prenatal services, including same-day appointments
Maternal fetal medicine consults at Lovelace Women’s Hospital for high risk pregnancies
Delivery at Lovelace Women’s Hospital’s birthing center
Medication-assisted treatment (in clinics and as outpatients)
Dedicated social workers to aid in the transition from clinic care to inpatient stay at Lovelace Women’s Hospital for delivery
Assistance from a social worker during the transition to the postpartum period
Access to Labor of Love, a free maternity navigation program available to mothers regardless of provider or insurance
Access to other community resources, including counseling programs
Intake is done via a screening questionnaire at the hospital’s clinic, so if a patient’s results present “at risk,” she may be confidentially and discreetly offered a variety of assistance options.
This blog post is an excerpt from the HealthStream article, SAVING G.R.A.C.E. - Program engages with at-risk mothers through prenatal care, delivery, and beyond. The article also includes:
Building a Training Program from the Ground Up
Targeting Behavioral Health as an Issue
Caring for Addicts Without a Withdrawal Program
Assessing Outcomes Key to Driving Forward Progress
Clinical development training, like that necessary for treating those affected by opioid addiction, is just one of the healthcare workforce development solutions offered by HealthStream for providers and employees. Explore HealthStream Clinical Development Solutions.