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Obstet Gynecol. 2019 Aug;134(2):365-375. doi: 10.1097/AOG.0000000000003381.

National Partnership for Maternal Safety: Consensus Bundle on Obstetric Care for Women With Opioid Use Disorder.

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Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania; the Center for Substance Abuse Treatment at the Substance Abuse Mental Health Services Administration, Washington, DC; UT Health San Antonio School of Nursing, San Antonio, Texas; the Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Premier Inc., Charlotte, North Carolina; the National Association of Nurse Practitioners in Women's Health, Washington, DC; Massachusetts General Hospital, Boston, Massachusetts; the California Maternal Quality Care Collaborative, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California; the National Organization on Fetal Alcohol Syndrome (NOFAS), Washington, DC; the Department of Family & Community Medicine, Center for Bioethics, Urban Health & Policy, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania; the Central Jersey Family Health Consortium, North Brunswick, New Jersey; the American College of Obstetricians and Gynecologists, Washington, DC; and the Department of Obstetrics and Gynecology and Psychiatry, Virginia Commonwealth University, Richmond, Virginia.


The opioid epidemic is a public health crisis, and pregnancy-associated morbidity and mortality due to substance use highlights the need to prioritize substance use as a major patient safety issue. To assist health care providers with this process and mitigate the effect of substance use on maternal and fetal safety, the National Partnership for Maternal Safety within the Council on Patient Safety in Women's Health Care has created a patient safety bundle to reduce adverse maternal and neonatal health outcomes associated with substance use. The Consensus Bundle on Obstetric Care for Women with Opioid Use Disorder provides a series of evidence-based recommendations to standardize and improve the quality of health care services for pregnant and postpartum women with opioid use disorder, which should be implemented in every maternity care setting. A series of implementation resources have been created to help providers, hospitals, and health systems translate guidelines into clinical practice, and multiple state-level Perinatal Quality Collaboratives are developing quality improvement initiatives to facilitate the bundle-adoption process. Structure, process, and outcome metrics have also been developed to monitor the adoption of evidence-based practices and ensure consistency in clinical care.

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