Substance use during pregnancy is a leading cause of maternal mortality and serious illness as well as newborn complications in the United States. Getting into treatment and receiving prenatal care can be lifesaving.
Daisy J. Goodman, DNP, MPH, CARN-AP, APRN, CNMDartmouth Health’s Dartmouth Hitchcock Medical Center (DHMC) has been awarded $900,000 in federal congressional funding, advanced by U.S. Sen. Jeanne Shaheen, to launch a first-of-its-kind dedicated inpatient program for pregnant patients with substance use disorders (SUD). This initiative addresses a critical healthcare gap and provides a vital safety net, positioning DHMC as a center of excellence for perinatal addiction care in New Hampshire and northern New England.
As the region faces an evolving addiction crisis, pregnant individuals struggling with substance use often encounter a dangerous lack of specialized resources. Highly toxic illicit substances, including fentanyl, xylazine, and medetomidine, have made withdrawal management increasingly unpredictable and medically complex, rendering standard outpatient care insufficient for many, especially during pregnancy.
In 2022, 12.5% of babies born at DHMC were exposed to substances including opioids, cannabis, and other drugs during pregnancy. And DHMC delivers more infants with prenatal substance exposure than any other hospital in New Hampshire. The DH obstetrics and gynecology department has provided inpatient withdrawal management for patients unable to transition onto medications for opioid use disorder since 2016, in collaboration with colleagues in the department of psychiatry and the highly regarded DH Moms in Recovery program. However, the challenge posed by the severity of substance exposure in our communities is accelerating, and no other hospital in the region currently offers a dedicated inpatient perinatal withdrawal management program.
“Substance use during pregnancy is a leading cause of maternal mortality and serious illness as well as newborn complications in the United States. Getting into treatment and receiving prenatal care can be lifesaving,” said Daisy J. Goodman, DNP, MPH, CARN-AP, APRN, CNM, an associate professor of obstetrics and gynecology at Dartmouth Health, who specializes in the care of pregnant patients with substance use disorders. “However, it is hard to transition from illicit drugs, especially fentanyl, to recommended treatment medications, given the mix of toxic substances that people are exposed to. The safest place to do this during pregnancy is in the hospital.”
The funding will transform two existing rooms within the DHMC Birthing Pavilion into a specialized suite equipped for safe withdrawal management and the initiation of treatment medications. Beyond infrastructure, the program establishes a multidisciplinary team, which includes a medical director, care coordinators, recovery-trained doulas, and behavioral health specialists, who will help manage the complex clinical and social determinants that patients dealing with SUD often face, such as housing instability, trauma, and domestic violence.
The initiative also extends its impact beyond the program itself by providing specialized SUD-focused training for hospital partners, including the neonatal, pediatric and medical intensive care units, pediatrics, and the emergency department. By creating a comprehensive, trauma-informed model of care, DHMC aims to double its patient capacity within the first year, providing stabilization, treatment initiation, and support for reintegration and continuity of care for both mothers and infants.
“We are thrilled to have received congressionally directed funds to help us create a warm and welcoming space at DHMC for our pregnant patients in need of support during this process,” said Goodman.
About Dartmouth Health
Dartmouth Health, New Hampshire’s only academic health system and largest private employer, serves patients across New England. Dartmouth Health provides access to more than 2,300 providers in nearly every area of medicine, delivering care at its flagship hospital, Dartmouth Hitchcock Medical Center (DHMC) in Lebanon, NH. Its network of hospitals, outpatient centers, clinics and home care facilities, spans a broad geographical area. Year after year, DHMC is named the #1 hospital in New Hampshire by U.S. News & World Report, and is consistently recognized for high performance in numerous clinical specialties and procedures. Dartmouth Health includes Dartmouth Cancer Center, northern New England’s only National Cancer Institute-designated Comprehensive Cancer Centers and one of less than than 60 total nationally; Dartmouth Health Children’s, which includes the state’s only children’s hospital (Children’s Hospital at DHMC/CHaD) and more than 20 locations around the region; eight member hospitals in Lebanon, Keene, Claremont, Hampstead, and New London, NH, and Windsor and Bennington, VT; Dartmouth Health Home Care; Dartmouth Health Connected Care Center for Telehealth, serving patients as far away as Texas; and more than 30 primary and multi-specialty clinics across New Hampshire and Vermont. Through its partnership with Dartmouth College, Dartmouth’s Geisel School of Medicine and the White River Junction VA Medical Center, Dartmouth Health trains nearly 400 medical residents and fellows annually and performs cutting-edge research and clinical trials with international impact. Dartmouth Health and its more than 16,000 employees are committed to serving the healthcare needs of everyone in the communities it serves and to providing every patient with exceptional, state-of-the-art, personalized care. Learn more at dartmouth-health.org.
About Dartmouth-Hitchcock
DARTMOUTH-HITCHCOCK HEALTH (D-HH), New Hampshire’s only academic health system and the state’s largest private employer, serves a population of 1.9 million across Northern New England. D-H provides access to more than 2,400 providers in almost every area of medicine, delivering care at its flagship hospital, Dartmouth-Hitchcock Medical Center (DHMC) in Lebanon, NH. DHMC was named in 2019 as the #1 hospital in New Hampshire by U.S. News & World Report, and recognized for high performance in 13 clinical specialties and procedures. Dartmouth-Hitchcock Health also includes the Norris Cotton Cancer Center, one of only 51 NCI-designated Comprehensive Cancer Centers in the nation; the Children's Hospital at Dartmouth-Hitchcock, the state’s only children’s hospital; affiliated member hospitals in Lebanon, Keene, and New London, NH, and Windsor, VT, and Visiting Nurse and Hospice for Vermont and New Hampshire; and 24 Dartmouth-Hitchcock clinics that provide ambulatory services across New Hampshire and Vermont. The D-H system trains nearly 400 residents and fellows annually, and performs world-class research, in partnership with the Geisel School of Medicine at Dartmouth and the White River Junction VA Medical Center in White River Junction, VT.