The obstetrics staff was surprised the first time it happened in June 2025. A pregnant woman who was dependent on methamphetamine arrived at the hospital in labor. She showed an image of graffiti spray-painted on a bridge in downtown Denver that read “Have your baby at Lutheran.” She was scared, and in pain, but wanted to be somewhere she felt safe asking for help.

Not long after, it happened again.

Another laboring woman with the same image on her phone. Apparently, word was getting around that this labor and delivery unit did things differently.

The women showed up at the hospital months after providers there had participated in a training program about caring for pregnant patients with substance use disorders.

After delivery, both women engaged with recovery services, which include meeting with peer support, attending recovery meetings and sometimes moving into either detoxification centers or sober housing. They remained connected to these support systems, which are designed to improve outcomes for parents and families affected by substance use disorders.

Substance use disorders are common in general, but also common among people who get pregnant. Many pregnant people report experiences of judgment, stigma and discrimination in healthcare settings. Research has found that fear of negative treatment can discourage patients from disclosing substance use, engaging in prenatal care or seeking treatment services.

These barriers may contribute to a disturbing trend: Overdose has become a leading contributor to maternal mortality. In Colorado, accidental overdose is the second-leading cause of death among people during pregnancy and the first year after birth. Between 2016 and 2020, 33 people in Colorado died of overdose during pregnancy or in their first year after birth.

I have spent much of my career studying substance use during pregnancy. For three years, I worked with the Colorado Perinatal........

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