Overview
No state has been as profoundly affected by the epidemic of substance use and misuse, especially opioid use, as West Virginia. For the last several years, the state’s rate of overdose deaths has been the highest per capita in the country and over double the national rate.
Substance use in pregnancy, including the use of tobacco, alcohol, prescription, and illicit drugs, has long been identified by West Virginia healthcare professionals as a major factor contributing to poor health outcomes for mothers and babies. Current statistics reflect 14 percent of West Virginia infants are born with intrauterine substance exposure. Fifty per 1000 babies born in the state are diagnosed with neonatal abstinence syndrome (NAS). This is significantly higher than the national rate of 7 per 1000 births.
Our Approach
We believe every pregnant and postpartum person with a substance use disorder deserves compassionate, nonjudgmental care and individualized services. Our programs support healthy outcomes for mothers and babies by providing prevention, early intervention, addiction treatment, and recovery.
“Integrated approaches to care that combine the medical and nursing team, behavioral health providers, substance use treatment providers, and community resources into a seamless partnership are critical to providing the best care for mothers and babies affected by substance exposure.”
– Janine Breyel
Deputy Director, WVPP
To address substance use in pregnancy and the alarming rates of Neonatal Abstinence Syndrome, the Partnership has developed a coordinated approach. Explore our collaborative projects:
Drug Free Moms and Babies Program
The Drug Free Moms and Babies Program is an integrated, comprehensive model of care for pregnant and postpartum persons with substance use disorder. The program reaches high-risk, medically underserved women and their infants. Continued success has led to increases in funding and statewide expansion of the program. The project has grown to 23 active programs.
Assessing Prevalence of NAS in Real Time
Numerous efforts to quantify the number of babies in West Virginia diagnosed with NAS historically resulted in frustratingly low numbers that did not reflect the reality of what neonatologists were experiencing in their hospitals. Over time it became apparent that inconsistencies existed in how at-risk infants were identified and diagnosed with NAS across the state. In 2014, the West Virginia Perinatal Partnership convened an expert panel consisting of neonatologists and other pediatric providers, policymakers, and hospital staff to develop standardized criteria for diagnosing NAS.
In 2016, the Partnership in collaboration with state leaders advocated to have questions about intrauterine substance exposure and NAS added to the Project WATCH Birth Score tool. The Birth Score is a risk assessment completed on every baby born in the state. In 2020, additional questions regarding the type of substance used were added to the data collection. The Partnership continues to work closely with Project WATCH, the program that administers the Birth Score and Office of Maternal, Child and Family Health, the state agency that funds Project WATCH to monitor and analyze the data to help influence policy decisions.
Intrauterine Substance Exposure & Neonatal Abstinence Syndrome (NAS)
To improve care of infants at-risk for neonatal abstinence syndrome (NAS), the West Virginia Perinatal Partnership worked with pediatric providers in the state to develop a standardized definition for diagnosing NAS, worked with state partners on a surveillance system to assess the prevalence of intrauterine substance exposure and NAS, and implemented an educational program on best practices for screening, diagnosing and caring for at-risk infants.
This project is funded by WV Department of Health and Human Resources, Bureau for Behavioral Health Claude W Benedum Foundation.
NAS Education Project to Keep Mothers and Babies Together
The Partnership conducts trainings and provides technical assistance to pediatric providers in a variety of inpatient and community-based settings. Evidence-based practices, such as the utilization of non-pharmacological treatment as a first line of treatment to manage neonatal withdrawal symptoms have been shared. The adoption of these modalities encourages mothers to stay with their newborns during the hospital stay.
Education also emphasizes breastfeeding when appropriate. These efforts have helped keep babies in their home communities by not requiring them to be transferred to hospitals with higher levels of care, saving the system money and improving quality by promoting mother and infant bonding.
A new curriculum provides community-based pediatric providers the latest evidence-based information on the effects of intrauterine substance exposure on children and resources available for families affected by this exposure. The education highlights policy changes to WV Project WATCH, specifically notifications being sent to pediatric providers on NAS diagnosis and Hepatitis C exposure. Best practices and evidence-based care for babies and young children affected by maternal substance are shared.
RCORP – NAS WV Rural Community Opioid Response Program
Rural communities experience significantly higher rates of substance use disorder in both the general and pregnant populations while bearing disproportionate socioeconomic burdens such as low incomes and high unemployment.
West Virginia Perinatal Partnership’s RCORP NAS project, funded by the US Health Resources and Services Administration, serves women at-risk for giving birth to an infant with NAS in Greenbrier, Pocahontas, and Randolph counties. The project, which focuses on improving integrated care and care coordination, builds upon the services provided at Drug Free Moms and Babies programs located in the rural service area. WVPP leads a Consortium made up of Davis Medical Center, Greenbrier Physicians, and the West Virginia School of Osteopathic Medicine that guides the activities of the project.
Healthy Expectations Resource (HER) Toolkit
The Healthy Expectations Resource (HER) Toolkit (web-based application) was developed in response to the rising rates of Neonatal Abstinence Syndrome in West Virginia and will help providers care for pregnant and parenting women with substance use disorder, as well as their infants and families. Through the Toolkit, multi-disciplinary providers in West Virginia will be able to locate local resources and access the latest information on best practices for this population.
Weave WV
Weave West Virginia addresses the oft-overlooked intersection of intimate partner violence and substance use disorder, particularly for pregnant and postpartum people. Intimate partner violence, including substance use coercion, is a major barrier to healthcare and social services that often prevents survivors from seeking support.
