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Pregnant and Postpartum Patients
Pregnant and Postpartum Patients Assessment
33. Clinicians should incorporate additional elements into the
comprehensive assessment of StUD for patients who are pregnant,
including:
a. providing referrals to prenatal care providers if not already established (L-S), and
b. reviewing eligibility criteria for locally available programs that specifically
address biopsychosocial needs related to pregnancy and parenting (eg,
childcare, Special Supplemental Nutrition Program for Women, Infants, and
Children [WIC] programs; L-S).
34. Coordination of prenatal care and treatment of StUD is encouraged
(L-S).
35. When screening for acute issues, complications, and sequalae
associated with stimulant use in patients who are pregnant,
clinicians should pay particular attention to factors that impact
pregnancy and fetal development (L-S).
36. Since the ramifications of a positive drug test result for patients
who are pregnant may be more severe than the general populations,
before conducting drug testing in patients who are pregnant,
clinicians should:
a. know their state's requirements on mandatory reporting and ramifications of
reporting (CC-S);
b. weigh the potential benefits with the risks of utilizing drug testing in this
population (CC-S); and
c. obtain informed consent, unless there is immediate clinical need and obtaining
consent is not possible (eg, loss of consciousness; CC-S).
Pregnant and Postpartum Patients Treatment
37. Risk versus benefit to the fetus or infant should be considered when
medications are used to manage StUD, stimulant intoxication, or
stimulant withdrawal (VL-S).
38. Wherever possible, clinicians should incorporate psychosocial
treatments targeted toward meeting the additional needs of patients
who are pregnant (CC-S), including:
a. Parent-focused treatment modalities (eg, parenting skills training ; CC-S), and
b. family-based treatment modalities (CC-S).
39. Clinicians should consider contingency management to incentivize
attendance at prenatal appointments, if feasible, in addition to usual
targets (eg, stimulant abstinence; L-S).
40. Clinicians should consider providing additional treatment support
around the time of birth, as the postpartum period may be a time of
increased stress and risk of return to stimulant use (VL-C).
