Joelle is a nurse who has worked in Perinatal and Neonatal Intensive Care since 2004, and in Harm Reduction since 2010. They became passionate about advocating for people who use drugs after realizing that everything they had been taught about drugs from childhood through nursing school was wrong.

Issue
Information on pregnancy and substance use is often conflicting and always confusing. Data analysis and reporting is biased toward dire conclusions which promote stigma and do not reflect study outcomes. This leads to inaccurate public health messaging and harmful policy decisions at every level. Pregnant and parenting people who use drugs, their families, and service providers deserve accurate, value neutral information to help them make healthcare decisions based on fact and not fear.

Setting
United States imperialism has ensured that our War on People Who Use Drugs is exported to every corner of the globe. The War on People Who Use Drugs causes particular harm to pregnant people and their children by influencing academic research, child welfare law, and public health messaging.

Project
The Perinatal Substance Use Toolkit is a collaboration between the Academy of Perinatal Harm Reduction and The National Harm Reduction Coalition in the United States. Development was led by people with living and lived experience of substance use and/or pregnancy. Our goal is that this information will be available to every person in the world, no matter where they live or what language they speak.

Outcome
The toolkit was released in September of 2019. It has been adapted to the context in several US states as well as internationally. We cover 6 classes of commonly used substances and discuss self-advocacy, prenatal care, pain control in labor, lactation, and navigating the legal and child welfare systems (where applicable). The updated toolkit released in October 2022 is available in English and Spanish and includes new information regarding vaping nicotine, naltrexone for opioid use disorder in pregnancy, and drug supply contamination.