BC doctors meeting the challenges of addiction among new moms

February 13, 2019

We are hearing a great deal about the growing challenge of opioid use and addiction in BC. It’s also a growing problem for new moms and their babies, as physicians in Fraser Northwest discovered.

While doing its research to create Primary Care Networks, the Fraser Northwest Division of Family Practice discovered that due to a fear of stigma, new moms dealing with addictions are facing significant barriers to care for themselves and their babies.

“We have noticed, in our referral-based clinic and through the doctor of the day patients, there are increasing numbers and complexity of pregnant patients with addictions and opioid use,” says Dr Jennifer Yun, whose job is to support patients who arrive at Royal Columbian Hospital (RCH) having received little or no prenatal care.  

Many of these moms have not been accessing prenatal care at all, only showing up at the hospital once they were already in labour. The division’s physicians and partners - Fraser Health and RCH - got to work to help these vulnerable moms and their babies.

The first step - training and education 

As a first step in determining how to reduce stigma and improve care for these patients, the division brought in a speaker from the Fir Square Clinic at BC Women’s Hospital and Health Centre. The clinic at BC Women’s Hospital provides specialist services to substance-using pregnant women and their babies, espousing a philosophy of ensuring that babies remain with their mothers while they are cared for during the process of withdrawing from prenatal substance exposure.

Dr Yun attended the session, and explains, “[The speaker] from Fir Square Clinic met with us to give us a best case scenario in managing the prenatal and perinatal, as well as postnatal care of these moms and babies. During that planning session, we learned that Fraser Health was working hard to create strategies like rooming-in of mom/babes during the neonatal period, and providing more supportive care than is provided in NICU.” 

With this knowledge in hand, the division organized training sessions to promote best practice recommendations for a number of aspects of neonatal care for addicted moms and babies. This training fostered a united approach to care amongst GPs, midwives, obstetricians, pediatricians, and nurses—for example, continuing to promote breastfeeding for addicted moms, recognizing that the benefits of breastfeeding outweigh the risk of opioids in the system. 

Innovation and change at Royal Columbian Hospital

Obstetrician Dr Mina Wesa and Pediatrician/Neonatologist Dr Miroslav Stavel

In response to the division’s research and training efforts, physicians at RCH are currently in the process of implementing the Fir Square Clinic model of care to support pregnant moms with substance use and newborn babies at risk for neonatal abstinence syndrome. These changes in care are supported by the hospital’s rebuild, which features private rooms where moms and babies can recover together. 

Dr Yun acknowledges the collective force of doctors and care providers in making change, saying “It was powerful to know that family doctors, midwives, obstetricians, and neonatalogists in our hospital, as well our nurses, are all very engaged and actively involved in this work to bring the best model of patient-centered care to these patients.”  

These changes will dramatically impact how maternity care is provided to addicted moms and babies. Dr Yun explains, “We are hoping to move towards keeping moms and babes together, longer in post-partum units, instead of separating them from the time of delivery. This knowledge shift in managing pregnant moms with opioid use means we have strategies to improve these moms’ and babies’ experience—valuing the role of mother to her baby, and vice versa, no matter what their background and life experience that came before to the mother.”  

It is just another example of how BC’s physicians are working with all our partners to make a real difference for patients and communities in BC.

Maternity care projects undertaken by Fraser Northwest division and other divisions of family practice around the province are supported by funding from Doctors of BC and the Ministry of Health, administered through the General Practice Services Committee and the Shared Care Committee. Visit gpscbc.ca/our-impact/maternity and sharedcarebc.ca/results/success-stories/fostering-collaboration-maternity-care to learn more.