Presented By: Lillian Lawrence, Geisel School of Medicine at Dartmouth
Co-Authors: Daisy Goodman, Geisel School of Medicine at Dartmouth

Purpose 
Perinatal substance use disorder (SUD) is an enlarging problem that contributes to morbidity and mortality for birthing people and infants. Outcomes improve when patients are treated for SUD, including pharmacologically, and when SUD treatment is integrated with obstetric care. However, OB/GYN residency training programs have not traditionally included content on SUD. Here, we examine the current state of OB/GYN residency training in treating perinatal SUD, with a goal of highlighting innovative programs, and improving the overall quality of training offered.

Methods 
We conducted a thorough literature search to identify OB/GYN residency training programs offering content on treatment of perinatal SUD, using relevant MeSH terms,as key words and phrases utilizing PubMed and Google Scholar databases, and also conducted a citation and cited by search of relevant articles and abstracts.

Results 
Our review revealed that few OB/GYN programs in the US have published about training residents to treat perinatal SUD. Of the 241 OB/GYN residency programs in the US, only three have reported outcomes of training programs focused on SUD. Of these publications, two were conference abstracts. All three demonstrated efficacy: OB/GYN residents who received training reported increased comfort treating perinatal SUD and were more likely to be x-waivered to prescribe buprenorphine.

Conclusions
Few OB/GYN residency programs have incorporated training in the treatment of perinatal SUD and published on the results of their programs. This gap may reflect a lack of training programs, perhaps due to stigma against pregnant people with SUD, or simply a lack of structured evaluation and publication of outcomes of programs that do exist. OB/GYN residency programs should incorporate and evaluate content on treating perinatal SUD, and address its direct harms to patients, through training new physicians in the compassionate treatment of SUD during pregnancy.