OB and Opioids
OSF HealthCare initiative aimed at drug use and pregnancy
Drug overdose is currently the leading cause of death in pregnant and postpartum women in Illinois. Since 2008, pregnancy associated deaths from opioid overdoses have increased one thousand percent.
Let that sink in for a moment. That fact comes from the Illinois Department of Public Health (IDPH) and is the reason why the Illinois Perinatal Quality Collaborative, or ILPQC, started a Mothers and Newborns Affected by Opioids (MNO) initiative - of which two OSF HealthCare medical centers are taking part.
One is Saint Elizabeth Medical center, in Ottawa. That's in LaSalle County, which, in 2017, was in the top five counties in the state for fatal opioid overdoses.
Therein is the correlation. If there is an opioid epidemic in the community, it's very likely that pregnant mothers are also impacted. In the year that Saint Elizabeth's Family Birthing Center has been involved in the ILPQC project it has identified and helped more mothers with substance use disorder.
All patients are screened using a validating screening tool - where broader questions about possible drug use involving the mother, her partner, family and friends - has helped bring this issue to the surface. Thus helping connect mothers to resources they may need and improving education for special infant care.
Education and awareness is helping destigmatize opioid use disorder and lets the mother know that the hospital staff is there to help.
"Identify these women early on in their pregnancy before they deliver," says Annabel Tomas, Director, Family Birth Center at OSF HealthCare Saint Elizabeth Medical Center. "But also getting the babies help, too. Because we see withdrawal symptoms with the baby too. So, it's keeping Moms and babies together - that is our focus. That's the focus of this initiative - is keeping Moms and babies together. But also with opioid use disorder being the number one leading cause of maternal death in Illinois - it's keeping these mothers alive."
Tomas and her staff admit they were unaware that opioid use was such a serious problem for mothers within the community and they have learned how to help mothers and infants affected because of their involvement in the ILPQC project initiative.
Through this new approach they have also discovered that most Moms want help, they just don't know where to get it.
"We try to coordinate with them," says Sandra Crawley, RN, Family Birthing Center, OSF HealthCare OSF Saint Elizabeth Medical Center. "With different clinics outside of here, with different treatment centers outside of here. We try to coordinate through the doctors to find earlier interventions for them. So that way they - cause they're having a baby and, I mean, 98 percent of the time they want to get better."
Crawley says that coordination includes the mother's OB physicians, pediatricians and their family. As part of the initiative they have put togehter a list of recourse to refer mothers and families to.
Because the newborn can also be affected, this initiaitive emphasizes immediate, intimate care of the baby by its mother while attempting to decrease length of stay and pharmacological use.
"We like to involve the Moms a little bit more in their baby's care," says Brandi Duffy, Lactation Consultant, OSF HealthCare Saint Elizabeth Medical Center. "So after the baby is born, instead of the baby being in the nursery, we like the Mom to stay and be a big part of the baby's care. So that they can help comfort and console their own child. So we reduce usage of medication in the infant, as well. Because the Moms are the best treatment for their baby."
Tomas says the Mothers and Newborns Opioids Use Disorder (MNO) initiative has and will continue to be best practice for Saint Elizabeth's Family Birthing Center.
In Illinois, 88 birthing hospitals are participating in the ILPQC MNO initiative.
In addition to OSF Saint Elizabeth, the project was also undertaken by the OB department at OSF HealthCare Saint Francis Medical Center in Peoria. The goal is to have all OSF birth centers involved.