Supporting compassionate, evidence-based care across Montana

Pregnancy and the postpartum period can be times of both great joy and significant challenge. For some, substance use may become part of that journey. Whether you are a healthcare provider, behavioral health professional, home visitor, peer support specialist, or family member, this resource toolkit connects you with trusted information, practical tools, and Montana-specific resources to support individuals who are experiencing perinatal substance use.

This toolkit and resources were created with the support of multiple Montana agencies and collaborators, including Montana State University, Healthy Mothers, Healthy Babies – The Montana Coalition, Billings Clinic, Postpartum Support International-Montana, One Health, and Nurse Family Partnership.

Explore the Toolkit

Understanding Perinatal Substance Use

What is perinatal substance use?

Perinatal substance use refers to the use of alcohol, medications, or other substances during pregnancy or throughout the first year after childbirth.

Every person’s experience is different. Some individuals may have a diagnosed substance use disorder, while others may use substances occasionally or during times of increased stress. Substance use often occurs alongside mental health conditions, trauma, chronic pain, or other complex life circumstances.

Understanding these complexities helps providers offer care that is compassionate, evidence-based, and centered on the needs of each family.

Perinatal Substance Use Disorder Education & Training Resources

Trauma-Informed Care

Every interaction matters

Trauma-informed care recognizes the impact of past experiences and emphasizes safety, trust, collaboration, empowerment, and cultural responsiveness.

Providers can support families by:

• Using respectful, person-centered language
• Explaining procedures before they occur
• Including patients in decision-making
• Being transparent about mandatory reporting requirements
• Recognizing strengths alongside challenges
• Supporting family goals whenever possible

Why language matters

The words we use influence how people experience care. Person-first, non-stigmatizing language helps build trust, supports engagement in treatment, and reduces barriers to care. Instead of labels, providers are encouraged to use language that recognizes substance use as a health condition rather than a moral failing.

Examples include:

• Person with a substance use disorder
• Positive test result instead of “dirty”
• Recovery instead of “clean”
• Medications for opioid use disorder (MOUD)

Reducing stigma begins with everyday conversations.

Trauma-Informed Care Education & Training Resources

Cultural Safety & Awareness

Culturally responsive care improves trust and engagement.

This section includes Indigenous-led resources, cultural safety training, and guidance to support culturally responsive care for Tribal communities throughout Montana.

Cultural Safety Training and Resources

Screening & Assessment

Universal Screening

Universal verbal screening helps identify opportunities for support while reducing bias in who is screened. Screening differs from toxicology testing and should be conducted using validated, evidence-based tools. Topics in this section include:

• When to screen
• Recommended screening tools
• SBIRT
• Screening versus testing
• Referral pathways

Resources include commonly used screening instruments such as 5Ps, SURP-P, NIDA Quick Screen, CRAFFT, TAPS, and others identified by Montana providers.

According to the American College of Obstetricians and Gynecologists (ACOG), screening for perinatal substance is use is recommended to begin at the first prenatal visit and is a component of comprehensive perinatal care. Universal screening through the use of standardized tools as well as referral for treatment should be completed in partnership with the pregnant person.

Policies for testing for substance use, through urine or meconium, vary by institution. It is recommended by the ACOG that all testing be completed with consent of the pregnant person.

Perinatal Substance Use Screening Tools & Resources

Professional Education & Clinical Resources

Explore evidence-based clinical guidance, research, training opportunities, and best practices to support high-quality care for pregnant and postpartum individuals affected by substance use. Resources cover screening, treatment, neonatal care, plans of safe care, fetal alcohol spectrum disorders (FASD), and other topics to support informed, compassionate clinical practice.

Professional Education & Resources

Montana-Specific Resources

Connect with organizations, programs, and services available throughout Montana that support pregnant and postpartum individuals and families affected by substance use. Browse statewide and local resources, including treatment providers, recovery supports, home visiting programs, peer services, housing resources, and other family-centered supports.

LIFTS Online Resource Guide

The LIFTS Online Resource Guide is a free, searchable directory connecting Montana families and providers with pregnancy, parenting, behavioral health, recovery, and community resources across the state. Search by location, category, or keyword to find the resources that best meet your needs.

LIFTS also helps families connect with trained doulas statewide who provide physical, emotional, and informational support during pregnancy, birth, and the postpartum period.

Look Closer Campaign

Look Closer is a Montana initiative focused on reducing stigma surrounding perinatal substance use disorders by promoting kindness, compassion, and connection. Through storytelling, educational resources, and community engagement, the campaign encourages supportive interactions that help individuals and families access care and recovery.

Home Visiting in Montana

Home visiting is a voluntary, proven support and coaching service that strengthens families through pregnancy and early childhood. Trained home visitors, such as nurses and early childhood specialists, work with expecting parents and caregivers of children through kindergarten entry to build parenting skills and connect families with needed services to support optimal physical, social, and emotional child development. To learn more about home visiting in Montana and statewide home visiting programs, visit the Montana Home Visiting Coalition webpage.

Montana-Specific Treatment & Recovery Resources

Mandatory Reporting in Montana

Who is required to report suspected child abuse or neglect in Montana?

Montana law requires certain professionals and other designated individuals to report suspected child abuse or neglect when they have reasonable cause to suspect a child has been abused or neglected. Mandated reporters include:

• Physicians
• Nurses
• Health and mental health professionals
• Teachers and school personnel
• Social workers
• Child care employees
• Law enforcement officers
• Clergy
• Other professionals designated under Montana law

Mandatory Reporting & Child Welfare Resources