moms+ toolkit
The pregnancy-associated death rate in Colorado has surged from 24.3 deaths per 100,000 live births in 2008 to 68.3 deaths per 100,000 live births in 2020. Suicides and overdoses continue to be the top two causes for non-pregnancy related maternal death, and the overwhelming majority of overdose deaths were attributed to opioids. 89% of these deaths were determined preventable - through better medical care, mental health care or substance-use treatment. The latest Maternal Mortality Review Committee (MMRC) reported that from 2016 to 2020, there were 174 maternal deaths in Colorado; the second highest cause of “non-medical” pregnancy-associated death was unintentional overdose (n=33). As COVID-19 has occupied the nation’s attention, the opioid overdose crisis has continued to accelerate in pregnant and postpartum people.
Colorado Perinatal Care Quality Collaborative (CPCQC)’s Turning the Tide Initiative
MOMs+ is an elective program for hospitals implementing the AIM Perinatal Substance Use Patient Safety Bundle through the Colorado Perinatal Care Quality Collaborative’s (CPCQC) Turning the Tide Initiative, formerly known as CO AIM: SUD. This patient safety bundle capitalizes on the hospital birth admission as the time pregnant people are most likely to interact with healthcare providers and focuses on universal screening, brief intervention, and referral to treatment for perinatal substance use.
Treatment protocols
Inpatient and outpatient order sets, dosing considerations and Subjective Opioid Withdrawal Scale (SOWS) details.
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MOMs+ Methadone Inpatient OB Order Set
MOMs+ Buprenorphine Standard Induction Inpatient OB Order Set
MOMs+ Buprenorphine Low-Dose Induction Inpatient OB Order Set
MOMs+ Opioid Withdrawal Inpatient OB Comfort Order Set
MOMs+ Buprenorphine Low-Dose Induction Outpatient OB Order Set
MOMs+ Buprenorphine Standard Induction Outpatient OB Order Set
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MOMs+ Stimulant Use Disorder OB Order Set- Inpatient
MOMs+ Stimulant Use Disorder OB Order Set- Outpatient
MOMs+ Alcohol Use Disorder OB Order Set- Inpatient
MOMs+ Alcohol Use Disorder OB Order Set- Outpatient
MOMs+ Cannabis Use Disorder OB Order Set- Inpatient
MOMs+ Cannabis Use Disorder OB Order Set- Outpatient
MOMs+ Nicotine Use Disorder OB Guidelines- Inpatient/Outpatient
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The MOms Initiative
Our goal is for 100% of hospital-based obstetric, labor and delivery, perinatal, and neonatal units to provide overdose education and naloxone distribution to at-risk pregnant and postpartum patients and families.
Patients
Find educational handouts, facts and treatment, risks and prevention, marketing posters
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Alcohol Use
Opioid Use
Stimulant Use
Cannabis Use
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Methadone
Buprenorphine
Naltrexone
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(waiting rooms, treatment areas, bathrooms)
Perinatal Substance Use Poster
Spanish Perinatal Substance Use Poster
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Clinicians
View training on Stigma and Bias, Treatment and Recovery, Harm Reduction and Naloxone, as well as Toxicology Guidelines. Learn more about Naloxone take home kits and how to have successful conversations with moms.
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▶ Treatment and Recovery Training
▶ Harm Reduction and Naloxone Training
▶ Toxicology Guidelines Training
▶ Perinatal Alcohol Use Training
▶ Perinatal Stimulant Use Training
▶ Perinatal Cannabis Use Training
▶ Perinatal Nicotine Use Training
▶ Doing Right by Birth Training
▶ Perinatal OUD Methadone Case Study Flyer
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▶ Colorado Public Health Harm Reduction Legislation guide (including 911 Good Samaritan Law)
▶ CDC Safe Injection Practices Guide
▶ National Harm Reduction Coalition Resources on Sex Work
▶ Drugs of Abuse, a DEA Resource Guide (pages 45-105)
▶ American Academy of Pediatrics resources on NOWS
▶ JOGNN recommendations on breastfeeding while on treatment for SUDs
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Finding Treatment
Find physicians and treatment programs providing medications (methadone, buprenorphine, suboxone, vivitrol, antabuse, naltrexone, naloxone, narcan) for the treatment of opioid addiction in Colorado counties.
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OBH's Opioid treatment program directory: Find programs providing medications (methadone, buprenorphine, suboxone, vivitrol, antabuse, naltrexone, naloxone, narcan) for the treatment of opioid addiction in Colorado counties.
SAMHSA's Opioid treatment program directory: Find programs providing methadone for the treatment of opioid addiction (heroin or pain relievers) state by state.
SAMHSA's Buprenorphine physician and treatment program locator: Find physicians and treatment programs providing buprenorphine for opioid addiction (heroin or pain relievers) state by state.
— our mission –
TO HELP ALL birthing hospitals provide substance use disorder treatment and recovery services to perinatal patients through connection and community.
This resource has been developed by the MOMs+ interdisciplinary team based on published evidence and expert opinion. This material should not be reproduced or disseminated without prior permission from MOMs+ or Stader Opioid Consultants, LLC.
This resource should never be used as a substitute for clinical judgment. Providers are responsible for assessing the unique circumstances and needs of each case. Adherence to this guideline will not ensure successful treatment in every situation. Developed in collaboration with Stader Opioid Consultants, LLC.