Expectant mothers with addictions to drugs or alcohol are treated by the Substance Abuse, Treatment, Education and Prevention Program (STEPP), a part of The Ohio State University Wexner Medical Center’s Maternal Fetal Medicine practice. This weekly clinic, held on Wednesday mornings, provides personalized high-risk obstetric care, treatment and counseling.
The majority of our STEPP patients have opiate addictions and participate in a treatment program – either through inpatient or outpatient programs aligned with Ohio State’s Wexner Medical Center, or through outside programs – as they work toward recovery. Additionally, our clinic cares for expectant mothers with infectious diseases, which are frequently (but not always) associated with illicit drug use.
Patients voluntarily join the STEPP clinic, which typically cares for 30 expectant mothers at a time. Although we accept patients at any point in their pregnancy, most seek treatment before 24 weeks of pregnancy.
For those recovering from narcotic pain medication or opiate addiction – including heroin, morphine, codeine, Oxycontin, Dilaudid or methadone – our course of treatment includes medication stabilization as a component of their care. Medication stabilization involves prescribing a controlled medication as a substitute for illicit drugs to help patients avoid an acute withdrawal phase during pregnancy, and closely monitoring their use of the medication. This approach reduces some of the risks that acute withdrawal may pose to the baby.
Patients with alcohol or amphetamine addictions are encouraged to participate in 12-step programs for support as they abstain during their pregnancy, such as Alcoholics Anonymous and Narcotics Anonymous.
Why Choose Ohio State?
The STEPP clinic has been a program of Ohio State’s Maternal Fetal Medicine practice for well over a decade. Managed by a maternal fetal medicine specialist in our high-risk obstetrics practice, the clinic’s approach is to stabilize the patient’s drug use by replacing illicit drugs with managed, prescribed medications. This treatment, combined with an emphasis on compassionate, nonjudgmental care, is designed to see you safely through pregnancy, delivery and follow-up, followed by recommendations for continued rehabilitation or maintenance medication programs.
It is rare to find a treatment program affiliated with a high-risk obstetrics practice. Because babies whose mothers abuse drugs and alcohol during pregnancy have higher risk factors for abnormalities, malformations, low birth weight and other complications, we place a special emphasis on providing comprehensive, thorough monitoring of our patients.
We also collaborate closely with an Ohio State pharmacist who specializes in determining the most appropriate dosages for expectant women. Through personal interviews and observation, this pharmacist helps us better manage the selection of your medications and dosage to help minimize acute phases of withdrawal.
Finally, we coordinate with the neonatologists at Ohio State’s Neonatal Intensive Care Unit (NICU)
to prepare for your baby’s care immediately after delivery. These specialists are experienced in providing compassionate care to babies in withdrawal, as well as in addressing any additional special needs your baby may have.
The STEPP clinic offers a variety of patient services customized to meet your unique needs, including:
Controlled Medication – For patients who are dependent on opiates, including heroin, morphine, codeine, Oxycontin, Dilaudid, methadone and others, we can prescribe Suboxone®. This prescription-based treatment’s chemical composition typically yields less severe withdrawal symptoms, potentially making it easier to taper off it as part of recovery. Patients who are prescribed this medication must participate in weekly substance-abuse group-counseling therapy. Additionally, patients must see their prescribing physician weekly.
Counseling – Patients whose care includes prescription-based medication stabilization are required to participate in weekly, hourlong group counseling sessions guided by a certified substance abuse counselor. Topics include issues specific to preparing for the birth of your baby and working toward recovery, including empowerment, self-esteem and relationships.
High-Risk Obstetrics – Women participating in this clinic receive weekly intensive prenatal care, with a urine drug screen, obstetric exam and discussion with the physician about medications, life stressors and other concerns. If needed, referrals to counselors and social workers are made.
Ultrasounds – Your baby’s progress will be monitored through routine ultrasounds using high-frequency sound waves (no radiation) and state-of-the-art technologies to evaluate the baby’s size, position and development. Ultrasounds are also used as a component of diagnosing developmental abnormalities.
Infectious Diseases – Because Hepatitis C and HIV are the two most common infectious diseases related to drug addiction, due to high-risk behaviors associated with illicit drug use, we collaborate with a team of Ohio State’s infectious disease physicians to coordinate any special care you may need in conjunction with your pregnancy. We are currently participating in NIH-funded research in conjunction with Nationwide Children’s Hospital to better understand Hepatitis C and pregnancy.
Newborn Care Planning – Prior to delivery, we coordinate with neonatologists from Ohio State’s NICU to meet your baby’s special needs. Your baby will be cared for during his or her own period of withdrawal, and will receive treatment for any complications that arise.
The STEPP clinic is available weekly on Wednesday mornings.
OSU Obstetrics & Gynecology at McCampbell Hall
1581 Dodd Drive
For more information, talk to your primary Ob/Gyn or call 614-293-8045.