Methamphetamine Use Disorder in Pregnancy

Objective: To understand care and outcomes in pregnant and postpartum individuals using methamphetamines in pregnancy.

Background: As methamphetamine use in America has increased, up 1% of all deliveries are now complicated by methamphetamine use representing over 37,000 maternal – infant dyads. Methamphetamine use in pregnancy is associated with increased risks of perinatal complications, including preterm delivery, low birth weight, gestational hypertension, and higher rates of stillbirth. Addiction care is characterized by poor engagement, continued use throughout the pregnancy, and poor continuation of care after delivery. High rates of loss of custody complicate the abilities of these women to establish the mother-child relationship.Proposal:The presenters will provide a summary of the literature related to methamphetamine use in pregnancy and in the postpartum period. The processes of prenatal and addiction care for individuals with methamphetamine use are made complex by insecure housing, frequent involvement with the criminal justice system, including incarceration. Many struggle with mental health disorders that go untreated. What can be offered to improve outcomes? Standard addiction and obstetrical care offer limited success. However, partnerships between the addiction providers and obstetricians offers some opportunity of improving outcomes. The presenters will describe recommendations for prenatal and addiction care for pregnant and postpartum individuals. Evidence-informed care suggests a greater focus on social determinants of health, mental health screening and linkage to care, and removal of punitive public policies, including child removals. Finally, the authors will present some models of integrated care that may prove useful for future investigation. This area is ripe for innovation and radical redesign of services.