Turning the Tide

Turning the Tide is Colorado’s statewide perinatal quality improvement initiative focused on improving outcomes for pregnant and postpartum people and their infants affected by perinatal substance use. Based upon an Alliance for Innovation on Maternal Health (AIM) Patient Safety Bundle, this annual initiative provides hospital-based teams with evidence-based tools, clinical best practices, and implementation support to enhance substance use screening, brief intervention, and referral to recovery treatment services. Turning the Tide promotes a compassionate, family-centered approach that reduces stigma by framing perinatal substance use disorder as a chronic and treatable medical condition.

Through active engagement in Turning the Tide—one of CPCQC’s quality improvement initiatives—hospitals can meet the quality improvement requirement set by Colorado Senate Bill 24-175.

Substance use during pregnancy is a growing public health concern linked to serious complications, including preterm birth, low birth weight, neonatal withdrawal, and increased risk of maternal illness or death. In Colorado, where 97% of births take place in hospitals, these care settings offer a critical window to identify and support individuals affected by perinatal substance use.

Perinatal substance use is more than a medical issue—it’s a matter of health equity. Too often, people who use substances during pregnancy face stigma, criminalization, and inconsistent care. These barriers worsen health outcomes and erode trust in the healthcare system. Turning the Tide seeks to change that narrative by supporting hospitals in delivering trauma-informed, non-punitive, and family-centered care. The initiative focuses on connecting patients with treatment and recovery supports, building coordinated systems of care, and ensuring that every person receives respectful, compassionate services that protect the health of both parent and baby.