A Baby STEPS (Substance use Treatment and Education PartnerShip)- healthy Mom's and Newborns

What if a community could rally around families who struggle with substance use instead of stigmatize them?

Photo of Laura Nelson
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Founding Story: Share a story about a key experience or spark that helps the network understand why this project got started or a story about how you became inspired about the potential for this project to succeed.

Within our community substance use disorder and opiate addiction has become an epidemic over the past decade. Pregnant woman are not immune to this reality and the number of babies being born exposed to substances has increased by over 300% in our community. An important dialogue began that lead to a stakeholder group forming to help develop educational tools for the health care sector and women of child bearing age. These tools help to facilitate conversations that are difficult but necessary.

Which categories describe you? (the answer will not be public)

  • White (for example: German, Irish, English, Italian, Polish, French, Caucasian)


http://www.nrvcs.org/ http://www.ipg.vt.edu/

Location: Where is your organization headquartered? [State]

  • Virginia

Location: Where is your organization headquartered? [City]


Location: Where is your project primarily creating impact? [State]

  • Virginia

Location: Where is your project primarily creating impact? [City]

Montgomery, Giles, Floyd, Pulaski, and City of Radford

Problem: What problem is this project trying to address?

Our stakeholders have identified the need for health care professionals to better identify woman at risk of using substances during pregnancy. Through interviewing women in recovery we/ve identified that there is a need to increase awareness and education about resources and services for both women and their children. The resource and tool guide we have developed addresses all of these issues and funding will help reach more women at risk.

In order to help the most vulnerable children in our community we need to break the multi-generational cycle of substance use. Through a collaborative effort of doctors, nurses, social workers, counselors, and researchers we have developed a set of tools that help begin important conversations between families and community health professionals. We are looking to build a strong continuum of care that starts with trust between families struggling with substance use and the community that wants to help them. The Care Notebook that we have developed for women of child bearing age and The Screening and Referral Toolbox for community health professionals has been received with great enthusiasm by all parties. We are looking for support to continue on this journey, to supply more resource guides, and through the unabating support of our community help to decrease the number of babies exposed to substances in-utero.


Is your model focused on any of the following traditionally underserved communities?

  • Children who are differently abled
  • Low-income communities

Does your model work within any of the following sectors?

  • Child and Family Services
  • Mental Health
  • Other

If you chose "other," please share the sector you work within here:

Substance use disorder and prenatal populations

Year Founded


Project Stage

  • Growth (the pilot has already launched and is starting to expand)

Example: Walk the network through a specific example of what happens when a person or group engages with your solution.

Through interviews with mothers struggling with substance use disorder and entering recovery we have learned that there is a real need to increase support and communication between them and their community resources. The Care Notebook was developed as a culturally competent tool that pregnant woman and their health care providers can use as a team throughout the woman's pregnancy and recovery. Through rigorous vetting and review by professional community stakeholders, the Virginia Handle with CARE legislative group, and an expert on prenatal substance use at SAMHSA the Care Notebook provides woman in our community much of the necessary information regarding prenatal substance use, neonatal abstinence syndrome, and recovery support.

Impact: What was the impact of your work last year? Please also describe the projected future impact for the coming years.

We have collected health care access, substance use, domestic violence, and neonatal abstinence syndrome data to determine the risky health factors our community faces and where services should be focused. We have conducted interviews with women in recovery and front line workers that can be found in the appendix of the attached context report. The major trend when asked what the communities greatest need is was twofold: 1) increase education within the target population of women of child bearing age 2) increase screening tools and resources for doctors to use as a point to facilitate a conversation on substance use. From our interviews we learned that it is very difficult to broach such a stigmatized topic. These resources address these information gaps. Additionally, our project is continuing to support a full continuum of care approach from prevention to evidence based treatment.

Organization Type

  • government

Annual Budget

  • $100k - $250k

Financial Sustainability Plan: What is your solution’s plan to ensure financial sustainability?

The goal of this project is to distribute the Care Notebook and Screening Toolbox to all health care professionals within the community serving prenatal populations. To date 40 copies have been distributed to local OB-GYNs and community health professionals who are eager to receive more. Funds received would help to support the materials needed to reproduce enough copies for all community health professionals. Materials will be maintained online.

Unique Value Proposition: How else is this problem being addressed? Are there other organizations working in the same field, and how does your project differ from these other approaches?

Within our community we have collaborated with several stakeholders that have identified various areas of need along the continuum of care for pregnant women; with intensive counseling being a main service. The project tools that we have developed are critical to helping decrease the number of babies born with neonatal abstinence syndrome because these tools help to bridge the gap of communication between mother and health care provider through a non-stigmatizing conversation. We are identifying more women who are in need of treatment and educating them on the importance a drug free pregnancy.

Reflect on the Field and its Future: Stepping outside of your project, what do you see as the most important or promising shifts that can advance children’s wellbeing?

It is important to recognize that a positive shift in care is occurring that categorizes substance use as a disorder rather than a 'life-style' choice in a trauma-informed manner. Substance use is a multi-generational issue that not only effects the parental user but their children as well. Helping a mother struggling with addiction will prevent unnecessary harm to her health and it will help potentially countless generations after her. Breaking the cycle of substance use and unhealthy behaviors associated with it will make community filled with happier and healthier children and families.

Source: How did you hear about the Children’s Wellbeing Challenge? (the answer will not be public)

  • Email


Join the conversation:

Photo of Doug Gould

Great job of building awareness of how substance use during pregnancy can impact unborn children. It would be interesting to explore the root cause of the increase in substance use among pregnant women in your community. Best of luck with your program.

Photo of Laura Nelson

Thank you for your comments! In our community we have looked into the high rates of prescription opiates and ease of access to prescriptions, high poverty and self-medication, as well as multi generational use and the culture surrounding substance and alcohol use across generations. 

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