Important Announcements

Nondiscrimination Policy Update

Boston Medical Center Health System complies with applicable Federal civil rights laws and does not discriminate on the basis of age, race, color, national origin (including limited English proficiency and primary language), religion, culture, physical or mental disabilities, socioeconomic status, sex, sexual orientation and gender identity and/or expression. BMCHS provides free aids and services to people with disabilities and free language services to people whose primary language is not English.

To read our full Nondiscrimination Statement, click here.

What to Expect During Pregnancy

Teaching Institution:

Project RESPECT is part of Boston University and welcomes learners and trainees, including addiction medicine fellows, residents, and students. Our goal is to support the next generation of doctors in providing exceptional care for mothers/parents with a history of substance use disorder. The care of all patients in Project RESPECT is directly delivered and supervised by the specialized RESPECT faculty and physicians.

Prenatal Visits:

You will have many appointments with us. When you start, we want to connect with you EVERY WEEK for 4 weeks. The frequency of your remaining visits will vary based on your gestational age and individualized medical plan.

There is no such thing as a silly question. Ask us any questions about your pregnancy, recovery, and physical health for you and your baby. Please don’t feel shy--the more you know, the more prepared you will be. We’re here to help!

Ultrasounds:

You will have 2 or more specialty ultrasounds to monitor the baby during your pregnancy:

  1. Between 11 – 13 weeks of pregnancy: This ultrasound is called the First Trimester Screen. You will also be offered blood tests to screen for genetic disorders.
  2. Between 18 – 20 weeks of pregnancy: This ultrasound is called a Fetal Survey. The purpose of this ultrasound is to check the baby's anatomy (heart, lungs, kidneys, etc.) We may be able to tell the sex of the baby at this visit.

Depending on your medical history and results of the first ultrasounds, you may be scheduled for additional ultrasounds throughout the pregnancy. We will explain these situations on an individual basis.

Relapse Prevention:

Relapse Prevention Counseling: We encourage new patients to meet with their Project RESPECT nurse care manager on a weekly basis to assess their medication plans and engage in relapse prevention planning. This could be with any member of your care team. These meetings may occur in person or virtually. We will assess the frequency of these visits after the first month of care and make adjustments based on your individual needs. We try to consolidate your prenatal, relapse prevention, and ultrasound visits whenever possible.

Urine Testing: As a standard of care, we recommend urine drug testing for all patients. The frequency of tests may vary person to person. This is not meant to be punitive but to provide the best treatment for you. Drug testing increases engagement in care, helps patients feel more open with their providers, and leads to better treatment outcomes. Our goal in urine testing is to ensure your treatment plan is the best one for you and to make any needed adjustments. If you have a positive (unexpected) urine test, we will call you within 24 hours to discuss the results, offer repeat testing, provide support, and discuss improving your treatment plan to reach your goals.

Project RESPECT will not discharge anyone based on urine test results.

Behavioral Health Care:

Individual Therapy: Many people in recovery have mental health needs, such as depression, anxiety, or trauma. Recovery has been shown to be more successful when these symptoms are treated concurrently with substance use disorder treatment. We recommend every patient has a therapist to talk with during their pregnancy and throughout the post-pregnancy period. If you do not have a therapist, we can connect you to one at Boston Medical Center or in the community.

Psychiatry: We recommend a consult with our perinatal addiction psychiatrist so our team can collaborate efficiently in support of your mental health. If you have an established relationship with an outside provider, we will request that you sign a release of information for supportive collaboration in your care.

We work with several community organizations and treatment resources to provide additional support.