At the core of Project Nurture is the integration of maternity care, substance use disorder treatment, peer support, care management, and the referral of patients to social service resources. Maternity care includes services such as prenatal care, maternity stay, postpartum care, breastfeeding support, and family planning services. Substance use treatment includes services such as SUD assessment, individual and group counseling, MAT, and coordination between treatment and prenatal/postnatal care. In addition to these clinical services, peer support and social services coordination is a critical component of the innovation. This includes peer mentoring on topics such as pregnancy, SUD recovery, and parenting, as well as coordinating with welfare workers on activities such as navigating welfare services, assistance programs, and judicial services.3
All sites operate slightly differently based on the scope of the providers within the organization, but there are commonalities and core elements of the project. Core members of the team include a maternity clinician (which could be a family physician, obstetrician, or a midwife), a certified alcohol and drug counselor, a case manager, and a peer recovery mentor/doula.2 Maternity care and Level 1 outpatient addiction treatment are provided weekly through treatment and maternity care groups. Counselors provide drug, alcohol, and mental health assessments, and trained peer recovery mentors or doulas are available as core members of the innovation team for a variety of peer mentoring needs.4 Critically, peer recovery mentors are not traditional community health workers, but rather must have lived SUD experience or be familiar with SUD care. The objective of this multidisciplinary provider team is to build trust and confidence in a nonjudgmental way to promote health and safety of both the mother and infant. By limiting strict programming requirements for patients, the program is able to move away from classifying patients as either compliant or noncompliant and instead focus on maximizing whatever levels of engagement are possible.