By Jessica Simon, Senior Program Manager, Health Systems Transformation, AMCHP
Recap
In December 2023, AMCHP & Association of State and Territorial Health Officials (ASTHO) unveiled a groundbreaking Maternal and Child Health (MCH) Journal Special Issue: Public Health Approaches to Perinatal Substance Use. This MCH Journal special issue serves as a vital resource, presenting 21 open-access articles that delve into the latest research, programs, and policy initiatives surrounding perinatal substance use disorder (SUD).
These articles touch on five strategic directions:
- Assessing the state of perinatal behavioral health
- Building a diverse and culturally competent perinatal behavioral health workforce
- Integrating perinatal and behavioral health care services
- Advancing non-punitive and harm reduction approaches
- Facilitating change by strengthening systems of care for perinatal people with substance use disorders.
Explore the summary of each article.
Reflections
We asked three key partners to reflect on this special issue and what it means for the field. The following series of questions and answers reflect responses from:
Nikki Bell-Peña, Founder of Living in Freedom Together (LIFT) Inc.
Co-author of an article published in the special issue, Prescribed and Penalized: The Detrimental Impact of Mandated Reporting for Prenatal Utilization of Medication for Opioid Use Disorder
Dr. Timothy Dye, Editor-in-Chief of the Maternal and Child Health Journal
Professor and Associate Chair for Research in the University of Rochester’s Department of Obstetrics and Gynecology
Dr. Michael Warren, Associate Administrator of the Health Resources and Services Administration’s Maternal and Child Health Bureau (HRSA MCHB)
What does this special issue mean to you?
Nikki Bell-Peña: “This [special issue] is critically important to me and also to the entire community treating pregnant and postpartum women. Those who have not been impacted by substance use disorder and pregnancy are often unaware of the policies and practices of hospitals that push women with substance use disorder to the margins and away from the high-quality care we deserve. The [special issue] raises this issue up and is lifting the voices of those most impacted.”
What does this supplement mean for the maternal and child health field?
Dr. Michael Warren: “Data from Maternal Mortality Review Committees in thirty-six states show that mental health conditions, including substance use disorder (SUD), are the leading underlying cause of pregnancy-related deaths. There is a great need and opportunity for those working in the maternal and child health field to develop new and innovative solutions to mental health conditions impacting pregnant and postpartum people and their families. This supplement supports that by providing public access to data and research on programs and policy initiatives to improve perinatal outcomes in families experiencing SUD.”
What is unique about this special issue?
Dr. Timothy Dye: “This special issue resulted in very interesting papers that contribute new insights to the field. The papers published represent a wide group of authors and perspectives. In an area as complex and heterogeneous as perinatal substance use, effective programming and policy really require the input of these various constituencies. It’s unusual in an academic journal to combine all these types of papers and I was so happy to see the results… and perhaps most importantly, this special issue is really a book, all appearing under one cover. People working in the field don’t need to hunt and search for the papers – they are all contained in one virtual or print version for future reference.”
Who do you think will benefit from this special issue?
Dr. Timothy Dye: “Far and away, this special issue primarily targeted practitioners of all types and is aimed at anyone who can use the results. But – in addition – many of the articles serve as templates and “role models” for others in the field, government, and academia who want to write and publish their ideas and work. These papers share ideas, models, perspectives, and formal studies. In the early stages, many of the authors didn’t feel they could contribute to an academic journal, that’s not been part of their experience before. In contrast, these papers are wonderful expressions of the authors’ insights and accumulated experiences. What a great way to train future generations of practitioners and writers! This Supplement will serve many, and I hope anyone who trains others in perinatal substance use will include some or all of these papers in their courses and activities.”
What do you hope public health professionals will take away from your article and from the special issue as a whole?
Nikki Bell-Peña: “I hope that people will be inspired to fight for continued policy change so that women like me are supported instead of penalized. We need allies to change these outdated and harmful policies and I hope our article inspires people to fight alongside those with lived experience.”
What are MCHB’s priorities regarding public health approaches to perinatal substance use?
Dr. Michael Warren: “The Bureau’s programs promote the physical and mental health and well-being of the nation’s mothers, children, and families, across the lifespan. Our investments aim to improve identification of mental health conditions, promote equitable access to mental and behavioral health care, and enhance the capacity of the MCH workforce to meet families’ mental and behavioral health needs. A few highlights include: the National Maternal Mental Health Hotline (1-833-TLC-MAMA), which provides 24/7, free, confidential support before, during, and after pregnancy, and the Screening and Treatment for Maternal Mental Health and Substance Use Disorders Program to help health care providers identify and address mental health and substance use concerns of women during and after pregnancy. Learn more about our programs that focus on mental and behavioral health.”
The insights shared within these articles can pave the way for a more informed, compassionate, and effective approach to perinatal SUD. As public health professionals continue to navigate the complex landscape of perinatal substance use, the release of this special issue serves as a call to action to transform the system through a holistic wellness lens for birthing people and families.
