Data to Action Success Stories: West Virginia

Expanding Reproductive Health Care Services to Reduce the Incidence of Infant Drug Withdrawal

Summary

When developing the West Virginia Opioid Response Plan, state officials used Pregnancy Risk Assessment and Monitoring System (PRAMS) data on unintended pregnancy and contraceptive use to help make recommendations to support women with a substance abuse disorder.

Problem

• In 2013, the opioid problem in the United States was at a peak and babies born often experienced drug withdrawals from being exposed in the womb to opioid use by their mother called neonatal abstinence syndrome (NAS). The NAS rate in West Virginia was estimated at 33 cases per 1,000 live births, compared with the national average of 6 cases per 1,000 that year. Infants born with NAS may need special medical care and have longer hospital stays.
• Ensuring access to quality, patient-centered contraceptive services is a strategy to reduce the incidence of NAS.

PRAMS Data to Action

• In 2017, the West Virginia Division of Perinatal and Women’s Health used PRAMS data on unintended pregnancy and contraceptive use to help the West Virginia Opioid Response Plan make recommendations for reducing NAS rates.
• PRAMS data from 2015 indicated that over 40% of pregnancies resulting in a live birth in West Virginia were unintended. Among women who reported their pregnancy was unintended, more than half were not using any contraceptive methods when they got pregnant.
• Using these findings from PRAMS data, the Opioid Response Plan included recommendations to expand access in multiple settings to voluntary, long-acting, reversible contraception, and other contraceptive services for individuals with a substance use disorder.

Results

• The West Virginia 2020–2022 Substance Use Response Plan highlighted several related successes that include:
  • Providing long-acting reversible contraceptives (LARC) such as subdermal implants or intrauterine devices (IUD) in the immediate postpartum period before hospital discharge.
  • Providing access to quality family planning in nine addiction facilities known as harm reduction sites to help individuals achieve their desired number and spacing of children.
• Through these programs, efforts have been strengthened to provide immediate postpartum LARC insertions in hospitals, and harm reduction sites have hired additional clinicians and purchased contraceptives.
• An increase in using contraception services and counseling among women at harm reduction sites was observed by the end of 2018, with continued monitoring to evaluate the program’s effectiveness.