Kate Mitchell, DNP, MS, RN, CNM, WHNP-BC, IBCLC

Abstract:

Pregnancy serves as a significant motivating factor for many pregnant people to reduce or abstain from substance use. However, many women relapse during the postpartum period. Additionally, in the United States, substance-use related deaths are a leading cause of maternal mortality. One potential targeted intervention is development of a lactation support program designed for patients with a history of substance use. Providing supported lactation services to this higher risk population may extend abstinence motivation from pregnancy to the postpartum period, reducing postpartum relapse rates and improving lactation rates. In addition to increasing contact during the postpartum period, targeted breastfeeding support may deter against substance use during an emotionally challenging period fraught with relapse triggers. The quality improvement project aim is to increase support for vulnerable patients through a pilot lactation program. The project lead evaluates the effectiveness of the pilot to impact breastfeeding rates, postpartum substance use, and maternal satisfaction. By pairing patients with a Certified Nurse-Midwife Internationally Board-Certified Lactation Consultant who focuses on patients with a history of substance use, obstetric practices may impact rates of breastfeeding and postpartum substance use while also achieving high levels of maternal satisfaction. Few studies focus on the unique needs of people with a history of substance use. As rates of substance use increase in the United States, focused research is needed to determine how to best support this population.

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