I-Team In-Depth

Yale Study Combining Opioid Use Disorder Treatment With OB-GYN Care Offers Hope To Pregnant Women Struggling With Addiction

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When Amanda, 28, found out that she was pregnant with her second child, she was in the middle of the COVID-19 pandemic and struggling with opioid use disorder. “I was pretty heavy into my drug use,” said Amanda, whose last name is being withheld due to patient confidentiality. “I had given up hope and was figuring out a way to use drugs and get away with the consequences. But it doesn’t work like that.”

Now, however, Amanda is feeling “really good.” That’s because she is in a clinical trial for pregnant women run by the Yale School of Medicine, through which she receives medication-assisted treatment (MAT) for her opioid use disorder (OUD). Amanda’s OB-GYN is among a group of physicians at 12 clinics in Connecticut and Massachusetts who are training with Yale to offer OB-GYN care and treatment for substance use disorder under one roof to pregnant patients.

I-Team In-Depth

Are OB-GYN Well Visits Short-Changing Women?

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During their childbearing years, many women view their obstetrician-gynecologists as primary care physicians, seeing them for preventive health care as well as for reproductive-related issues. Several studies, including one published in 2014 in the Journal of the American Medical Association (JAMA), indicate that women may be shortchanging themselves by consulting only an OB-GYN for preventive health care visits. The national study of 63 million preventive health visits by non-pregnant women found that those “of reproductive age who see OB-GYNs only for preventive care may not be receiving the full spectrum of recommended screening and counseling.”

A number of Connecticut OB-GYNs and other women’s health care specialists said, however, that they are aware of the unique role they play, and that they make a point of addressing patients’ broader needs, especially when meeting a new patient. These needs vary, of course, depending on a woman’s lifestyle, risk factors and age. “If you’re young, in your 20s, don’t smoke and are healthy, you’re very low risk,” said Dr. Susan Richman, a Branford OB-GYN.   “What [those patients may] have is very treatable, and I’m comfortable treating them.”

The JAMA study of “well-woman” visits from 2007 to 2010 showed that while OB-GYNs generally screened for cervical and breast cancers, chlamydia and osteoporosis, general practitioners more often screened for colorectal cancer, cholesterol counts and diabetes.