Pregnant and parenting people who use drugs can face severe legal repercussions, including the involvement of child welfare agencies, 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.
The good news is that harm reduction strategies centering the health, autonomy, and dignity of pregnant and parenting people who use drugs can increase racial and health equity, prevent overdose, and improve maternal health outcomes.
“Creating Safe Care: Supporting Pregnant and Parenting Patients Who Use Drugs,” a toolkit created by the Camden Coalition in New Jersey with support from Vital Strategies, equips health care providers with the knowledge and tools they need to support pregnant and parenting people who use drugs. It aims to make a report to child welfare services a last resort only.
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.
The toolkit equips health care workers to adopt a family-focused, whole-person approach when working with pregnant and parenting people who use drugs. Having access to quality maternal health care and social support without the fear of criminalization is crucial, not only for racial and health equity but also for overdose prevention and prevention of maternal mortality. Overdose is a leading cause of maternal mortality in the United States.
The toolkit 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. “Creating Safe Care” is meant to serve as a guide for implementing best practices and evidence-based practice models.
The toolkit is organized into five main sections:
- Treatment planning
- Providers as partners
Each intervention in the toolkit is evidence-based. Worksheets, tools and sample forms that can be easily replicated and used in care settings are included, as well as templates for family court letters, motivational interviewing scripts, health screening tools and other resources.
“Creating Safe Care” comes at a crucial time as reproductive rights are being rolled back in the United States. On June 24, 2022, 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 affects Black, Indigenous, and other people of color seeking an abortion, amplifying barriers such as out-of-state travel costs and systemic racism in health care. Many experts worry that state-level abortion bans and “fetal personhood” measures will lead to even more severe legal repercussions for pregnant people 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 Aug. 4, 2022 at 1 p.m. New Jersey time to highlight the toolkit and evidence-based strategies that health care providers can use. 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 Aug. 4, 2022 webinar.
Authors: Kyli Rodriguez-Cayro, Content Manager, Overdose Prevention Program at Vital Strategies and Emily Wasuna, Program Manager for Field Building and Resources, Camden Coalition