News & Updates — FORE Announcements

In anticipation of Mother’s Day, FORE celebrates moms and our grantees who care for mothers impacted by opioid use disorder (OUD) by connecting them to evidence-based treatment and promoting nonpunitive policies that help families stay together and thrive. Overdose deaths among women who were pregnant or postpartum increased sharply between 2018 and 2021, and are a significant contributor to high maternal mortality rates in the U.S. Fentanyl and other synthetic opioids are a large factor, but so, too, is the stigma that deters people with substance use disorders (SUD) who are pregnant or parenting from seeking help. Fears of poor treatment from health care providers and family separation by child welfare services drive patients away rather than toward pregnancy and postpartum services.

As part of our efforts to support populations at highest risk of overdose and OUD, FORE awarded grants to seven organizations that are developing innovative models that improve care for patients with SUD during pregnancy and the postpartum period. We are excited to showcase two of these grants in new videos that illustrate how providers, health care systems, and public health agencies can create more welcoming access points for people with SUD seeking treatment and support to build healthy families.

Team Lily, a clinic at Zuckerberg San Francisco General Hospital, was designed to make it easier for patients affected by mental illness, SUD, homelessness, and intimate partner violence to access perinatal care. “Anyone who is facing barriers getting into a standard four-walled pregnancy clinic, we’re ready to take care of,” says Dominika Seidman, MD, MAS, an obstetrician-gynecologist at the University of California, San Francisco (UCSF) and San Francisco General Hospital. To build trust, Team Lily sends navigators and social workers to meet pregnant patients in shelters, encampments, and homes. They also prioritize meeting patients’ basic needs, including food and shelter. An evaluation, funded by FORE, found that three-quarters of all patients in the program with an SUD received treatment and left the hospital with their babies. At one year of life, 90 percent of Team Lily babies were up-to-date on their well-child visits.

Doing Right at Birth, a training program created by researchers at the Friends Research Institute and UCSF, is designed to educate clinicians and hospital staff about the harms that may result from reporting families affected by SUD to the child welfare system, often as the result of indiscriminate urine drug testing. The training covers the history of the child welfare system, its impact on families and early childhood development, and the ways in which urine drug tests are being misused or misinterpreted. “What we’re trying to do with the course is interrupt the test-and-report chain,” says Mishka Terplan, MD, MPH, Medical Director of the Friends Research Institute and co-principal investigator of the project. Terplan and Sarah Roberts, DrPH, from UCSF, who co-leads the project, also support a cohort of healthcare providers who have committed to pursuing changes in drug testing and reporting practices and policies within their own institutions, communities, and states, so they are aligned with individualized, patient-centered care.

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