Birth parent assessment for OUD treatment with medication (MOUD)

During the postpartum period new mothers are at higher risk of return to use. The AAP supports the recommendations from the American College of Obstetricians and Gynecologists for early universal screening for substance use during the initial prenatal visit. This screening may be completed by a family medicine, obstetrician, midwife using a validated screening tool, such as the “4 Ps” for adults and the “CRAFFT” tool for adolescents. Optimal care for the birth parent with OUD begins with medication for OUD (MOUD)–typically methadone or buprenorphine. In addition, comprehensive psychobehavioral care and peer/community support increases engagement and supports positive treatment outcomes. 

Best practices during the postpartum period include:

• Encouraging the mother to continue treatment
• Assessing recovery status and challenges periodically
• Completing follow-up and check-in calls to maintain a positive relationship
• Engaging the mother’s peers and other sources of social support
• Conducting periodic screenings for postpartum depression and eliciting any concerns about treatment adherence
• Having conversations about how mental well-being and postpartum depression may challenge recovery

Providers involved on the psychobehavioral care and peer/community side may include:

• Social workers
• Psychologists
• Lactation consultants
• Physical therapists
• Occupational therapists

Common recovery supportive services should also be evaluated and provided when needed. These include:

• In-patient, residential, or long-term living facilities
• Outpatient services, including MOUD, dual diagnosis)
• Transportation
• Domestic violence shelters/crisis centers
• Food and nutrition assistance
• Parenting assistance for early recovery, such as postpartum doulas, childcare, and home visiting programs
• Resiliency support, which may include counseling/therapy, meditation groups, and community groups