In Colorado, a silent crisis is claiming the lives of expectant mothers at an alarming rate. From 2016 to 2020, 44 pregnant and postpartum individuals died from unintentional overdoses—a number tragically comparable to those who died from medical complications (42) in the following three years from 2020-2023.
While these figures might appear small in isolation, they represent preventable deaths that are driving a disturbing trend. Unintentional overdoses have surged to become the second-leading cause of pregnancy-associated deaths in Colorado, with rates nearly doubling from 15.6% in 2016 to 26.2% in 2020, according to the state's Maternal Mortality Review Committee.
These aren't just statistics—they're children who grow up without their mothers, families forever changed by preventable loss. This growing crisis has prompted the University of Colorado College of Nursing to take action through their Recovery Coach Doula Program, which is now expanding beyond the Denver metro to reach pregnant people across the Front Range. Services made possible through a $700,000 Opioid Response Strategic Impact Grant from the Colorado Attorney General’s Office will reach—in addition to the Denver Metro—Fort Collins and Pueblo.
Recovery Coach Doula Program Partners
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“It’s huge that the state recognizes the program and the need for funding so it can expand and offer essential services,” CU Nursing Assistant Professor Brie Thumm, PhD, CNM, RN, MBA, FACNM, says. “Substance use is not limited to just Denver or the Denver metro. It’s an issue that needs to be addressed across the state.”
The grant will fund the program’s expansion for two years, offering support surrounding all phases of pregnancy to more Coloradans. CU Nursing has been collaborating with partners since October 2024 to establish referral systems and coordinate logistics so that doulas can start offering services in early March.
“Our goal is to expand more broadly into Colorado’s rural and frontier communities, so expanding to Pueblo and Fort Collins is the first step since they’re bigger population areas,” Thumm says.
How the Program Works
The Recovery Coach Doula Program supports pregnant people with substance use disorder during pregnancy, birth, and the first year after birth. Trained recovery coach doulas (also known as peer support specialists) with specialized doula training meet with patients to offer emotional and physical support, help them adjust to life in recovery, and give insights on pregnancy, birth, substance use, and recovery.
“A recovery coach doula is someone who’s in long-term recovery from substance use disorder,” recovery coach and doula Britt Westmoreland says. “We use our lived experience and education to support our patients with advocacy and wellness. We also focus on other things like how to find a job, forming healthy relationships, and relapse prevention.”
Patients are referred to the Recovery Coach Doula Program through their prenatal clinics and hospitals.
“Everything is based on the request and needs of the patient. They’re the ones driving the conversation,” Westmoreland says. “The services are based on how frequently the client wants to see us, and so is the form of communication, whether it’s in-person or virtual.”
A Blueprint for Success
Part of the expansion also includes funding from Colorado’s Behavioral Health Administration to study and implement a blueprint for the program to develop in Colorado and beyond. Liza Creel, PhD, who does healthcare policy research with the CU School of Medicine, will help study the program’s sustainability.
“We’re figuring out how all of the support and services we’re developing at the Anschutz Campus can reach people in different settings,” Thumm says. “There are challenges for sustainability in rural areas, including geographic dispersion of clients and client volume, so we need to research how to make this program sustainable for not only clients but employees.”
“This has always been one of my long-term goals,” Westmoreland says. “The grant funding is showing enough people want us to succeed. I’m hopeful in the future we can use this blueprint to expand services not only in Colorado but in other states.”
