The Project RESPECT team members include four buprenorphine-waivered obstetric providers, an addiction certified psychiatrist with experience in perinatal mood, two RN care managers, a clinical social worker specializing in gender-specific care and trauma, and a child life-specialist to support attachment/attunement and bonding. The Project RESPECT team supports patients throughout their recovery journey during the entire first year postpartum.
Dr. Saia is very attentive, caring, and thorough and answers question that any patient can understand! She has worked very hard to help me in every way possible to feel better. I have been through a lot in the last 2 years. I've seen several doctors, but Dr. Saia is the one who has helped me the most. She is determined to make sure I am feeling better. Thank You Dr. Saia for everything!"~ Nicole W.
Massachusetts is one of the top states for access to treatment for substance use disorders, especially for pregnant women. Still, only 66 percent of pregnant women with substance use disorders in Massachusetts receive treatment before giving birth. Project RESPECT, a Boston Medical Center program that engages pregnant women in recovery, is working to change that statistic.
“Substance use disorder is the highest cause of maternal mortality, even when mothers are in the hospital post-delivery,” says Kelley Saia, MD, director of Project RESPECT. “It’s always a challenge to engage high-risk, high-utilizing patients fully in care, but our goal is to engage them in ongoing recovery treatment.”
Addiction Treatment Before Delivery
Project RESPECT sees an average of 45 patients a week for medical treatment and counseling. More than 60 percent of Project RESPECT’s referrals come from detox centers around Massachusetts. These patients are admitted to BMC’s high-risk obstetrics service for up to two weeks, where Project RESPECT helps connect them to services and get on medication-assisted treatment. The goal is to find out what patients need and want, but help guide them to treatment.
After connecting patients to appropriate treatment programs, the Project RESPECT team works with them throughout pregnancy and beyond. The team acts as care providers, a support system, a resource for advice, and an advocate in the legal and social systems when necessary.
Addiction Treatment After Delivery
Most importantly, Project RESPECT’s work doesn’t stop when the baby is born. “We’ve spent the last 15 years focused on prenatal care, but it turns out that after delivery is the most dangerous time,” says Saia.
Instead of the traditional six-week postpartum check-up, Project RESPECT schedules three appointments – for one week, three weeks, and five weeks out – with new mothers before they even leave the hospital. They then continue to see mothers at regular intervals and check in frequently to ensure that everyone is staying on track. The program's partner in this care is SOFAR, another BMC program that provides support and resources for mothers in recovery and their children in pediatric primary care.
Conditions We Treat
Treatments & Services
We offer monitored, acute substance withdrawal treatment and induction of medications for opioid use disorder in pregnant patients seeking treatment. Intensive, individualized out-patient treatment plans are outlined for each patient based on the severity of their disease, their individual goals, and their recovery progress. The out-patient medical home model provides on site, collaborative and multidisciplinary care for pregnant and post-partum patients in recovery.
The Project RESPECT clinical team collaborates and coordinates care with the inpatient Obstetric, Pediatric, Psychiatry, Social Work, Nursing and Lactation teams at Boston Medical Center to provide supportive and informed care. They also have developed strong partnerships n with multiple community based organizations including local methadone clinics, residential addiction treatment centers, the Department of Public Health, and the Department of Children and Families.
Caitlin Clark, MSW, LICSW
Clinical Program Manager
Ingrid St. Hill, MA
Janette McKinnon, BSN RN
Nurse Care Manager
Carol Ann O'Connor, BSN RN
Nurse Care Manager
Karissa Giovannini, MSW LICSW
Social Work Manager
Nicole J Phillips, MSW LCSW
Clinical Social Worker
Annalise Elsasser, MSW LCSW
Clinical Social Worker
Phaedra Moore, BA
Peer Recovery Specialist
Nicollette Johnson, MPH
Nadeen Ibrahim, A.B.
Quality improvement initiative to improve inpatient outcomes for Neonatal Abstinence Syndrome - Wachman EM, Grossman M, Schiff DM, et al. . J Perinatol. 2018;38(8):1114-1122. doi:10.1038/s41372-018-0109-8
Opioid addiction in pregnancy. - Shainker SA, Saia K, Lee-Parritz A. Obstet Gynecol Surv. 2012;67(12):817-825. doi:10.1097/OGX.0b013e3182788e8c
Caring for Pregnant Women with Opioid Use Disorder in the USA: Expanding and Improving Treatment. - Saia KA, Schiff D, Wachman EM, et al. Curr Obstet Gynecol Rep. 2016;5(3):257-263. doi:10.1007/s13669-016-0168-9
Naltrexone Treatment for Pregnant Women With Opioid Use Disorder Compared With Matched Buprenorphine Control Subjects - Wachman EM, Saia K, Miller M, et al.. Clin Ther. 2019;41(9):1681-1689. doi:10.1016/j.clinthera.2019.07.003
Prenatal treatment for opioid dependency: observations from a large inner-city clinic. - Saia K, Bagley SM, Wachman EM, Patel PP, Nadas MD, Brogly SB. Addict Sci Clin Pract. 2017;12(1):5. Published 2017 Jan 13. doi:10.1186/s13722-016-0070-9
Residency and Fellowship Information
Addiction Medicine Fellowship
Mission of the Grayken Fellowship in Addiction Medicine is to train physician addiction medicine leaders in clinical care, research, education, public health, and advocacy to improve addiction care for people vulnerable to health inequities due to race, ethnicity, gender, poverty, age, disability or stigmatizing illness.
The Grayken Addiction Medicine Fellowship Program is a 1 or 2 year fellowship. There is also a 3-year combined Infectious Disease-Addiction Medicine Fellowship and a 2-year Fellowship in Maternal Health Addiction. Fellows are mentored by our multidisciplinary faculty from Internal Medicine, Infectious Disease, Emergency Medicine, Obstetrics & Gynecology and Addiction Psychiatry. The Grayken Fellowship in Addiction Medicine is accredited by the ACGME. Click here to learn more
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