Moms Do Care EMPOWER (MDC-E)

Description

Baystate Franklin Medical Center, Pioneer Women's Health, and the Center for Human Development in rural Greenfield, Massachusetts, operate the Moms Do Care EMPOWER (Engaging Mothers for Positive Outcomes with Early Referrals) program to help pregnant and postpartum people with substance use disorder (SUD) or in recovery access care, peer support, counseling, and other services.

The program is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Massachusetts Department of Public Health's Bureau of Substance Addiction Services.

Services offered

• Team of care coordinator, clinical providers, full-spectrum peer-mentor doulas, nurse navigator, and recovery coach
• Breastfeeding and lactation support
• Counseling, if a participant is unable to access local behavioral health services
• In-home prenatal and postpartum visits
• Peer mentor support from people with lived experience in recovery
• Support for pregnancy and parenting in recovery
• Support and advocacy for families involved with the Department of Children and Families
• Trauma-informed midwifery care
• Assistance with navigating the healthcare system
• Help accessing community resources
• “Care Team” of representatives from programs like early intervention, community action, Women, Infants, and Children (WIC), and domestic violence prevention/intervention

Participants can receive support from doulas before, during, and after childbirth and meet with a Doula Support Navigator for help with birth plans and information about how to care for a baby experiencing withdrawal symptoms and what to expect during a hospital stay.

MDC-E helps participants prepare a Plan of Safe Care (POSC) during their pregnancy, in accordance with Massachusetts law for pregnant people with a history of SUD. This process is especially important whenever it can be reasonably anticipated that hospital social workers will file a report with child welfare and/or when a participant was previously involved with child welfare. As part of this process, MDC-E assists in gathering letters of support from prenatal providers and MOUD prescribers and works to reduce stress and trauma for participants. MDC-E also holds monthly meetings with the local Department of Children and Families office in order to build relationships and trust.

Patient eligibility:

• 18 years or older
• Pregnant or parenting a child under 36 months
• Current or past experience with substance use, including alcohol, nicotine, or THC
• History of medication for substance use or history of overdose

Results

MDC-E participants receive an average of 20 contacts with staff in every 30-day period. Peer support services are 70% of these contacts. Program coordinators report the following results at follow-up (6 months after enrollment), in comparison with baseline data (the day of enrollment):

• 5% increase in the number of participants who haven't experienced negative consequences as a result of SUD
• 20% increase in feelings of social connectedness
• 5% increase in total abstinence from all substances
• No increase in arrests within 30 days

At the time of discharge, 96% of participants attended most planned services.

A former participant said of the program: “Moms Do Care literally saved my life. If it wasn't for them, I would have had no direction when I first became a mother and your support was critical not only to my recovery, but to me becoming the mother I am today.”

Challenges

Program coordinators report that 82% of participants have mental health diagnoses and 72% of participants have been diagnosed with opioid use disorder. These conditions combined with living in the most rural part of the state can make it harder for people to participate in MDC-E.

Replication

Build relationships with midwives, obstetricians, and labor and delivery nurses in the region. Group training and professional development on topics like harm reduction and treating childbirth pain for patients using opioids or MOUD help healthcare professionals better understand their patients and improve their confidence in treating patients with SUD or in recovery.

Contact Information

Josefa Scherer, MPH, PM, BFMC, Program Manager
Moms Do Care EMPOWER
413.654.7116
Josefa.scherer@baystatehealth.org