Dartmouth-Hitchcock Issues Guidance For Treating Pregnant Women With Substance Use Disorders

Mar 26, 2018

Dartmouth-Hitchcock Medical Center has released an online "toolkit" to help doctors and nurses better serve mothers with substance abuse disorders and their babies.

The number of babies in Vermont, and across New England, who are born with neonatal opioid withdrawal syndrome — also called neonatal abstinence syndrome — has increased, and the online toolkit was put together to better coordinate the services and treatments that are available.

From the Vermont Department of Health — Data on Newborns with Opioid Exposure [April 2017]

“The maternal child health community knew that we were caring for more babies with neonatal opioid withdrawal, we were caring for more mothers who had opiate use disorder,” says Daisy Goodman, a nurse-midwife at Dartmouth-Hitchcock. “We didn’t feel like we were doing a consistent or standardized or evidence-based job for all of them, and we felt that we needed to really pull it together and make that happen.”

The 15-chapter toolkit includes a care provider checklist and specific lab tests to order when a pregnant woman with a substance abuse disorder comes in for care.

"We know there is a huge variation in the way that this population of women with opiate use disorder who are pregnant, are being cared for. And we also know that there is a right way to do it." — Daisy Goodman, Dartmouth-Hitchcock Medical Center

“We know there is a huge variation in the way that this population of women with opiate use disorder who are pregnant, are being cared for,” says Goodman. “And we also know that there is a right way to do it. And so the goal of the toolkit is to allow practices to facilitate implementing the best care.”

Before releasing the toolkit, the resource was tested at eight medical facilities across Maine, New Hampshire and Vermont, including at Southwestern Vermont Medical Center in Bennington.

Goodman says that during the pilot study, more women were screened for hepatitis C and were given access to the lifesaving drug naloxone. She also says newborn birth weights increased and the preterm birth rate went down at participating sites.

Disclosure: Dartmouth-Hitchcock Medical Center is a VPR underwriter.