We believe every pregnant and postpartum woman with a substance use disorder deserves compassionate, nonjudgmental care and individualized services. The Drug Free Moms and Babies (DFMB) program supports healthy outcomes for mothers and babies by providing prevention, early intervention, addiction treatment, and recovery support.
This project is made possible through generous support from the West Virginia Department of Health and Human Resources, Bureau for Behavioral Health, Bureau for Public Health, Office of Maternal, Child, and Family Health, and the Claude Worthington Benedum Foundation.
The DFMB Project works in communities by integrating medical and behavioral healthcare through a strong care coordination model that incorporates wrap around recovery support services and social services. While all sites are built upon the central hub of care coordination and provide required service components, they have the flexibility to provide services in a way that meets local needs and demands and is responsive to available resources.
Key Project Components
- Screening, Brief Intervention, Referral and Treatment (SBIRT) services integrated in maternity care clinics
- Collaboration with community partners for the provision of comprehensive medical, behavioral health, and social services
- Long term follow up for two years after the birth of the baby provided by a recovery coach. In addition, home visits and other services to help women maintain sobriety and access needed resources are provided.
- Program evaluation of effective strategies for identifying women in need, preventing addiction and abuse, treating women with substance abuse problems, and delivering recovery coaching services.
- Provider outreach education to other maternity care clinics in West Virginia to facilitate the duplication of successful model programs.
DFMB Project Sites
DFMB Manual (.pdf)
DFMB 2021-22 Report
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Drug Screening by Trimester
DFMB participants are required to undergo drug tests at a minimum of once per trimester. Negative drug screens rose from 25.1% at baseline to 64.2% at delivery. Women positive for illicit substances decreased from 74.9% at baseline to 35.8% at delivery. This is significant evidence of the ability of the DFMB program to affect behavior changes in participants and help them remain free from substance use.
Umbilical Cord Test Results
Critical to the program evaluation, all DFMB sites are required to collect and test the umbilical cord tissue of each infant born to a program participant. Of the 795 tests returned in 2020 and 2021, 67% were negative for illicit substances. Two-thirds of women in the program were successful in delivering babies free of illicit substances.
Diagnosis of Neonatal Abstinence Syndrome (NAS)
All infants born to a DFMB participant are screened for NAS at birth. For women using medication for opioid use disorders, NAS is an expected and treatable outcome that is discussed by program providers during the prenatal period so mothers are prepared to deal with the diagnosis and treatment of their babies. Twenty-eight percent (28%) of the babies born to women in the DFMB Program were diagnosed with NAS. Of those, over half (57.1%) of the babies’ umbilical cord tissue was positive for prescribed substances only. Symptoms of NAS may vary in severity depending on the type of substance(s) used, the last time it was used, and whether the baby was born full-term or premature.
Infants Discharged to Mother’s Care
DFMB sites work closely with Child Protective Services before and after birth to ensure the safety and wellbeing of babies. According to attachment theory, humans are born with a need to form a close emotional bond with a caregiver. Starting in infancy, humans develop mental representations of the caregiving relationship based on their early experiences. These mental representations of the caregiving relationship are thought to influence expectations and interactions in relationships, including parent-child relationships in the next generation.21 Supporting secure mother-infant bonds are critical for healthy development. The vast majority (74%) of infants born to DFMB participants were discharged to their mother’s care, giving the best chance for parent-child bonding.