{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:11:21Z","timestamp":1787015481513,"version":"build-2736575974"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T00:00:00Z","timestamp":1651622400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Perinatal opioid use disorder (OUD) is associated with maternal and neonatal morbidity, and treatment has been definitively shown to improve outcomes for both. As of 2018, certified nurse\u2010midwives (CNMs) can prescribe buprenorphine for the treatment of OUD by obtaining a Drug Addiction Treatment Act waiver. This research aims to identify the number of CNMs who are waivered to prescribe buprenorphine for the treatment of OUD and who practice in priority areas for treatment expansion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Through a descriptive study design, authors collected and analyzed publicly available data from August 2020 to January 2021. Using the software GeoDa, authors identified priority counties in the United States and the number of waivered and nonwaivered CNMs in these areas. Counties were designated as priority if they had drug\u2010poisoning mortality rates in the top 20th percentile of all US counties and no health care providers waivered to treat OUD or had a waivered health care provider per population rate in the bottom 20th\u00a0percentile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Analysis identified 141 priority counties in 23 states concentrated in rural areas throughout the Appalachian region of the United States. Tennessee had the most priority counties of any state. As of 2020, only 26 CNMs in the United States were waivered to prescribe buprenorphine, none of whom practiced in priority counties. Of the CNMs practicing in priority counties and without waivers, 59% (39 of 66) practiced in states where CNMs have independent practice authority.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>CNMs are uniquely positioned to treat perinatal OUD given their scope of practice as primary and reproductive health care providers, especially in rural, underserved areas. To increase the number of midwives prescribing buprenorphine and expand treatment access, researchers, educators, practice leaders, and policy makers must address barriers to and experiences of treating OUD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jmwh.13364","type":"journal-article","created":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T09:53:44Z","timestamp":1651658024000},"page":"314-320","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Expanding Opioid Use Disorder Treatment in Priority Areas: The Role of Certified Nurse\u2010Midwives"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9679-6650","authenticated-orcid":false,"given":"Claire","family":"Kane","sequence":"first","affiliation":[{"name":"Visiting Scholar Robert Graham Center for Policy Studies in Family Medicine  Washington District of Columbia"},{"name":"ABSN\u2010DNP Nurse Midwifery Student University of Washington School of Nursing  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3864-6507","authenticated-orcid":false,"given":"Michael","family":"Topmiller","sequence":"additional","affiliation":[{"name":"Health GIS Research Specialist in HealthLandscape Department at the American Academy of Family Physicians  Leawood Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,4]]},"reference":[{"issue":"2","key":"e_1_2_8_2_1","first-page":"e81","article-title":"ACOG committee opinion 711: opioid use and opioid use disorder in pregnancy","author":"Mascola MA","year":"2017","journal-title":"Obstet Gynecol"},{"issue":"1","key":"e_1_2_8_3_1","first-page":"80","article-title":"Prospective randomised comparative study of the effect of buprenorphine, methadone and heroin on the course of pregnancy, birthweight of newborns, early postpartum adaptation and course of the neonatal abstinence syndrome (NAS) in women followed up in the outpatient department","volume":"29","author":"Binder T","year":"2008","journal-title":"Neuro Endocrinol Lett"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6731a1"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.09.028"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017\u20103520"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.3750"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.20851"},{"key":"e_1_2_8_9_1","unstructured":"Substance Abuse and Mental Health Services Administration.Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and Their Infants.SAMSA;2018."},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.03.022"},{"key":"e_1_2_8_11_1","unstructured":"2017 NSDUH detailed tables. 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