Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 May 24:11:1045745.
doi: 10.3389/fped.2023.1045745. eCollection 2023.

Principles of care for pregnant and parenting people with substance use disorder: the obstetrician gynecologist perspective

Cecily May Barber  1   2 , Mishka Terplan  3   4
Affiliations
Review

Principles of care for pregnant and parenting people with substance use disorder: the obstetrician gynecologist perspective

Cecily May Barber et al. Front Pediatr. .

Abstract

Substance use in pregnant and parenting persons is common, yet still underdiagnosed. Substance use disorder (SUD) is one of the most stigmatized and undertreated chronic medical conditions, and this is exacerbated in the perinatal period. Many providers are not sufficiently trained in screening or treatment for substance use, so gaps in care for this population persist. Punitive policies towards substance use in pregnancy have proliferated, lead to decreased prenatal care, do not improve birth outcomes, and disproportionately impact Black, Indigenous, and other families of color. We discuss the importance of understanding the unique barriers of pregnancy-capable persons and drug overdose as one of the leading causes of maternal death in the United States. We highlight the principles of care from the obstetrician-gynecologist perspective including care for the dyad, person-centered language, and current medical terminology. We then review treatment of the most common substances, discuss SUD during the birthing hospitalization, and highlight the high risk of mortality in the postpartum period.

Keywords: addiction; disparities; parenting; pregnancy; stigma.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. Terplan M. Substance use and use disorder in pregnancy and postpartum. Int Rev Psychiatry. (2021) 33(6):501. 10.1080/09540261.2021.1981098 - DOI - PubMed
    1. Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: results from the 2020 national survey on drug use and health, ed. N.S.H.-. HHS Publication No. PEP21-07-01-003. 2021, Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
    1. Ebrahim SH, Gfroerer J. Pregnancy-related substance use in the United States during 1996–1998. Obstet Gynecol. (2003) 101(2):374–9. 10.1016/s0029-7844(02)02588-7 - DOI - PubMed
    1. Peltier MR, Roberts W, Verplaetse TL, Burke C, Zakiniaeiz Y, Moore K, et al. Licit and illicit drug use across trimesters in pregnant women endorsing past-year substance use: results from national survey on drug use and health (2009–2019). Arch Womens Ment Health. (2022) 25(4):819–27. 10.1007/s00737-022-01244-6 - DOI - PMC - PubMed
    1. Martin CE, Terplan M, Krans EE. Pain, opioids, and pregnancy: historical context and medical management. Clin Perinatol. (2019) 46(4):833–47. 10.1016/j.clp.2019.08.013 - DOI - PubMed