Improving Maternal Health for People with Opioid and Substance Use Disorder
With funding from the North Carolina Division of Public Health’s Injury and Violence Prevention Branch, NCHF launched a new initiative in September 2025 to improve care for people with substance use disorder (SUD) during the perinatal period, from pregnancy through one year postpartum. In partnership with hospitals across North Carolina, NCHF is working to identify and address barriers to evidence-based SUD care, as well as gaps in the services and supports available to this high-risk population.
In the 2018-2019 NC Maternal Mortality Review Committee (MMRC) report, 18 of the state’s 20 substance use disorder (SUD)-related maternal mortality cases involved opioids (primarily fentanyl).i In the latest report, mental health conditions (including overdose and suicide) were the leading cause of pregnancy-related death. A particularly crucial and sobering finding was that 87% of the pregnancy related deaths were ruled preventable.ii
Phase 1:
NCHF is currently of Phase 1 of this work, conducting a statewide survey of clinicians and other professionals who care for pregnant and postpartum people with SUD, including opioid use disorder. NCHF is also hosting focus groups to learn directly from people who have experienced substance use during the perinatal period.
Phase 2:
NCHF will launch Phase 2 of this work in the fall of 2026. The DPH Maternal OUD Initiative supports the statewide expansion of the Perinatal Substance Exposure Education (PSEED) training—an evidence-informed model developed through Project CARA at MAHEC—into inpatient hospital settings. The program will adapt PSEED for hospital-based providers at the delivery bedside, equipping interprofessional teams to deliver trauma-informed, stigma-reducing, and patient-centered care for birthing persons affected by substance use.
Five (5) hospitals will participate in this training, to be co-designed with hospital clinicians, doulas, perinatal substance use teams, patients, and peer support specialists.
Interested in learning more about bringing PSEED training to your hospital? Contact Madison Ward Willis at mward@ncha.org