Providers

Pregnancy and Parenting Support

Pregnancy and Parenting Support Program Flyer

Referrals: HCA Community and Nursing Services

Public health staff provide free of charge, individualized support to pregnant and/or parenting clients and can help with the following:

  • Pregnancy and health concerns
  • Health education
  • Monitoring growth and development
  • Connecting your clients with services and resources
  • Support with health, emotional, alcohol or substance use concerns

Programs include:

  • Adolescent Family Life Program (AFLP)
  • Nurse-Family Partnership® (NFP)
  • Perinatal Assessment and Coordination Team (PACT) and Medically High Risk Newborns (MHRN)

Eligibility criteria may apply

Perinatal Mood and Anxiety Disorders (PMAD)

Perinatal mood and anxiety disorders (PMAD) include a spectrum of mental health conditions that occur during pregnancy or up to one year postpartum. Many women experience mild mood changes during or after the birth of a child, including postpartum “blues”, which occur in 50-80% of women and are considered normal.  However, when symptoms persist beyond the first 2-3 weeks after giving birth, are more intense, or interfere with daily activities, they may be a sign of a PMAD, such as depression or anxiety.  Prior to the COVID-19 pandemic, estimates suggested that 13-21% of women experience PMADs.1 However, recent reviews suggest that both depression and anxiety in pregnant individuals have increased significantly during the pandemic, up to nearly two-fold for depression (27%) and three-fold for anxiety (42%).2,3,4  Addressing PMADs promptly is critical for the health and well-being of the mother, infants and young children.

Additional information on PMAD

Orange County Perinatal Mental Health Toolkit

Mental health resources

1Kendig S, Keats JP, Hoffman MC, et al. Consensus bundle on maternal mental health: perinatal depression and anxiety. Obstet Gynecol. 2017;129:422–430. [PMC free article] [PubMed] []

2Racine N, Eirich R, Cooke J, et al. When the bough breaks: a systematic review and meta-analysis of mental health symptoms in mothers of young children during the COVID-19 pandemic. Infant Ment Health J. 2022;43:36–54. [PMC free article] [PubMed] []

3Tomfohr-Madsen LM, Racine N, Giesbrecht GF, Lebel C, Madigan S. Depression and anxiety in pregnancy during COVID-19: a rapid review and meta-analysis. Psychiatry Res. 2021;300 [PubMed] []

4Zhang CXW, Okeke JC, Levitan RD et al. Evaluating depression and anxiety throughout pregnancy and after birth: impact of the COVID-19 pandemic. Am J Obstet Gynecol MFM. 2022 May;4(3):100605, https://doi.org/10.1016/j.ajogmf.2022.100605.

Plans of Safe Care (POSC)

Plans of Safe Care should be developed for families with infants who may have been substance exposed during pregnancy.  Ideally the POSC should be developed during pregnancy, as POSCs promote supportive, potentially protective linkages to community resources and services for infants affected by prenatal substance exposure and their families.1

Any provider involved in the care of a pregnant person or infant affected by substance use can initiate the development of the POSC.  These providers include:

  • Obstetrics/gynecology (OB/GYN) and primary care doctors
  • Substance use disorder treatment providers or recovery coaches
  • Mental health providers
  • Pediatricians
  • Staff from home visiting programs
  • Hospital social workers/case managers
  • Faith leaders or counselors

More information on POSC and templates

*Note:  Federal law requires that infants born affected by substance misuse, withdrawal, or fetal alcohol spectrum disorder (FASD) receive a Plan of Safe Care that supports their families as well.

1Deutsch SA, Donahue J, Parker T, et al.  “Impact of Plans of Safe Care on Prenatally Exposed Infants.” The Journal of Pediatrics,  vol. 241, February 2022, pp. 54-61.37, https://doi.org/10.1016/j.jpeds.2021.10.032.

POSC Resources for Providers

The following plenary sessions were from the 2022-2023 National Center for Substance Abuse and Child Welfare (NCSACW) Policy Academy and have helpful information that all providers working with families affected by substance use should be familiar with:

Screening, Assessing, and Treating Pregnant Women with Substance Use Disorders: Dr. Mishka Terplan discusses his research and clinical work with pregnant women facing substance use disorders (SUDs). The session explores screening for SUDs during pregnancy, engaging women in treatment, and providing patient- and family-centered postpartum care.

Newborns Exposed to Substances: Understanding Their Needs and Supporting Their Caregivers: Dr. Stephen Patrick shares information about meeting the needs of infants with prenatal substance exposure and what health care for these children should include. He also discusses Firefly, a program at Vanderbilt University Medical Center to reduce the toll the opioid crisis takes on pregnant/postpartum women and their infants.

Common Developmental Trajectories of Children with Fetal Alcohol Spectrum Disorder: Dr. Douglas White describes the effects of prenatal alcohol exposure on neurodevelopment, traces the brain-based developmental and behavioral manifestations of prenatal alcohol-related brain injury across childhood and adolescence, and highlights similarities and differences between other neurodevelopmental disorders, such as Autism and ADHD.