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How providing naloxone in labor and delivery units can save lives

opioid overdose pregnant people
Posted at 10:24 AM, Jan 02, 2023

DENVER, Colo. — Nearly 107,000 Americans are lost to overdose every year and that number is only expected to rise because of the current fentanyl crisis.

Among those at risk are new mothers and pregnant individuals.

"So we have to overcome a lot of that when it comes to reimagining and readdressing the disease of addiction," Dr. Donald Stader said. "This is an area of tremendous stigma within medicine and really within society period."

A year ago, he embarked on a journey to change hospital policy statewide in Colorado by sending naloxone home with patients from emergency rooms. It's a lifesaving medication that reverses or reduces the effects of opioids. Phase two of the project focuses on labor and delivery units.

"Overdose and suicide are the top killers of pregnant women in the country and in Colorado. That should give all of us as Americans a hard pause," Stader said.

Rachael Duncan, the co-chair of the Colorado Moms Initiative, says addressing the stigma is at the center of fixing this issue.

"Dispelling some of the rumors around what happens if I am using substances as a pregnant or a postpartum patient," Duncan said. "The biggest barrier for a patient is stigma and continues to be."

Those spearheading this effort emphasize that giving out naloxone isn't just about the compound, they say it's also about the connection with the patient.

"What we can do as a first step is really de-stigmatize that conversation at the bedside. So we talk frankly and openly about substance use and if a mother or a pregnant person is using substances— to then use that as an opportunity to provide naloxone and say, 'Your life matters, the life of your child matters,' and we want you to be alive and be a health mom once your child is born," Stader said.

As a perinatal nurse practitioner, Mari Gambotto has already experienced the success this approach can have.

"I was super excited because it was really the gateway to help with forming a bond with these moms for them to feel like they could talk to us and they could open up," Gambotto said. "What I would like to say to those moms is there is help out there and it's not your fault that this is going on and we can walk the path together."

Trust and support are what lead to people seeking out treatment.

"And what treatment does is the most amazing thing, is it reunites that person with their health and it allows that mother or that pregnant person to be an amazing parent when that child comes out," Stader said.

This approach has already caught the attention of other states.

"We are actually concentrated as a nonprofit at piloting this in 10 different states coming in 2023," Stader said.

They plan to keep working until every hospital across the country is providing this crucial medication and support so many new moms and pregnant people need.