Elizabeth Wahl, left, Pregnancy Promise Program manager, and Carey Michels, Pregnancy Promise Program specialist, at the Labor of Love conference giving out information about the program. The free, voluntary program for pregnant Medicaid members in Indiana with substance use disorder was awarded a grant to allow it to expand.
SUBMITTED PHOTO
Indiana’s ability to help more mothers-to-be with addiction — and save the lives of moms and babies — is growing.
The state announced the expansion of its Pregnancy Promise Program, designed to help more expectant and new mothers with substance use disorder, including those in Johnson County. The state’s Family and Social Services Administration received a three-year federal grant worth up to $2.7 million from the Substance Abuse and Mental Health Services Administration.
The expansion will allow the program to support an additional 300 pregnant Indiana residents over the next three years, with a focus on those living in rural and under-resourced communities.
“Our goal is to really try to end these generational cycles of trauma and substance use. We know when mom is healthy and well, it increases the infant’s ability to grow and develop and thrive,” said Elizabeth Wahl, manager of the Pregnancy Promise Program. “If we can start supporting mom in pregnancy, well before the baby’s birth and help mom feel secure and stable and healthy, we know that’s only going to benefit the infant and the rest of the family.”
The Pregnancy Promise Program has become a cornerstone of keeping mothers and their babies safe. While maternal and infant mortality rates are decreasing slightly across Indiana, data from the most recent Indiana Maternal Morality Review Committee’s annual report shows substance use disorder and overdose continue to be a leading cause of maternal death in the state.
The report found that overdose, both accidental and undetermined intent, was the top cause of pregnancy-associated deaths in 2018, 2019, 2020 and 2021.
Those figures helped precipitate the Pregnancy Promise Program. The vision was to bring in additional federal funding to help improve the outcome for both women and babies affected by substance use disorder.
Since launching in 2021, the Pregnancy Promise Program has supported more than 900 mothers. The idea is to offer pregnant women and infants support from the prenatal period through 12 months postpartum, said Dr. Dan Rusyniak FSSA secretary.
“Not only are we helping mothers find treatment and sustain recovery, but we also ensure infants have an established pediatrician, appropriate referrals to pediatric specialists as needed, and developmental support services,” he said.
The Pregnancy Promise Program partners with Indiana Medicaid managed care health plans to provide case management and care coordination services to participants. Anyone can make a confidential referral to the Pregnancy Promise Program on FSSA’s website.
They receive highly skilled support from an experienced nurse or social worker through the Medicaid health plan, ensuring pregnant individuals are receiving treatment and health care in their local community.
To make the program work, state officials work with Centerstone, which provides Johnson County and other regional counties with mental and behavioral health care, as well as Volunteers of America’s Fresh Start, a residential treatment program.
“We do a host of screenings and assessments to determine exactly what type of care and treatment an individual needs,” Wahl said. “Then we literally connect them to the services in their local community, since these organizations offer those specialized services.”
Centerstone already has a robust program to help individuals with substance use disorder, including pregnant women. Last year, the organization treated 75 pregnant women.
“Many of those women have been in and out of treatment, prison, jail. They have regular involvement with (the Department of Child Services). All of them are 200% or below the poverty level,” said Jennifer Fillmore, director of substance use residential and specialized services. “And a majority of these women have not received any kind of prenatal care prior to admission. So we need all the resources we can get to make sure these women and their infants are successful in recovery and continue to thrive.”
Volunteers of America became active with the Pregnancy Promise Program in 2023, using a grant to create a program called Fresh Start Connect. The program included nurse home visits for postpartum treatment as well as prenatal care.
Their role is to help care for people who might fall outside the parameters of the Pregnancy Promise Program, but could still benefit from help.
“Their criteria are very specific. When we were talking, we started connecting that our program at VOA could serve some of the folks who had been referred to Pregnancy Promise but didn’t meet that criteria,” said Sayward Salazar, director of the Volunteers of America Fresh Start Recovery Center in Winchester. “We’re able to be that safety net that don’t meet that criteria.”
Benefits of the program include high rates of sustained recovery for mothers, continuity of medications prescribed to treat opioid use disorder, prevention of preterm births and maintaining healthy infant birth weights. The program also helps people get access to resources to address unmet health-related and social needs including stable housing, transportation, food security and child care, leading to family preservation and reunification.
“It can be really challenging accessing this care when you’re pregnant and also in the face of addiction to seek out all of this support,” Wahl said. “The program comes alongside people to help them get there.”
The results have been impressive. In the program’s 2023 annual report, officials tallied 364 people who had enrolled during pregnancy, with another 179 enrolled during the early postpartum period. Of those participants, 94% maintained recovery through 12 months postpartum.
Their babies were healthy as a result. Statistics showed 83% had a healthy birth weight, while 72% were discharged after five days.
With this new grant, officials will be able to expand services and hopefully make more gains.
The funding will also expand outpatient treatment and recovery support services for pregnant and postpartum women with a substance use disorder, as well as promote a coordinated system of care across health care and family support providers.
“What this new funding will allow us to do is really strengthen the specialized services for pregnant individuals with substance use in some of our more rural and underserved areas of the state,” Wahl said. “We want to create more robust services, supports, resources for pregnant individuals in those local communities.”
Centerstone is already a key provider of mental and behavioral health services throughout the state, and the grant helps strengthen the partnership with the Pregnancy Promise Program. Funding will also pay for a position at Centerstone to bridge the organization’s services with the program, Fillmore said.
“That’s something we didn’t have before this grant, and that will further help people not fall through the cracks and continue to be engaged,” she said.
