Sapphire Clinic: Integrating Addiction Medicine and Obstetric Care for Pregnant People Who use Substances

Abstract

Pregnant people who use substances face significant barriers to antenatal care, including stigma, institutional mistrust, fragmented service systems, and co-occurring psychosocial complexities including housing instability, trauma, justice involvement and mental illness. These factors contribute to late presentations, disengagement, and ultimately poorer perinatal outcomes. When pregnant people who use substances access antenatal care earlier, outcomes improve, including lower rates of preterm delivery and increased infant birthweights. As such, there is a critical need for flexible, integrated, and compassionate models of care that address the barriers that exist for this population.