Substance Use in Pregnancy

Substance Use in Pregnancy

Project CARA: Care that Advocates Respect/Resilience/Recovery for All

Welcome to the MAHEC Project CARA Clinic! Our mission is to decrease barriers and the stigma that prevent pregnant women with substance use disorders (addiction) to getting quality obstetrical care as well as access to the substance use treatment that they deserve.

We are part of the Maternal-Fetal Medicine (high-risk pregnancy) division and we are an integrated, comprehensive program that consists of the MAHEC OB team as well as vital partnerships, including Women’s Recovery Center, Mission Health System, and JFK Alcohol and Drug Abuse Treatment Center. Our team of healthcare providers is dedicated to serving pregnant women in Western North Carolina who also have substance use disorders.

Specialty Services (in addition to routine obstetrical care)

  • Office-Based Opioid Treatment (OBOT) - We have trained providers to prescribe buprenorphine for pregnant women who suffer from opioid use disorder and desire/are appropriate for treatment
  • Substance Use Support - Access to dedicated licensed clinical addiction specialists both through MAHEC OB/GYN Specialists and partnering community agencies to provide 1:1 counseling, group therapy, as well as referral assistance to access additional or higher level services
  • Neonatal Abstinence Syndrome (NAS) counseling and detailed delivery planning
  • Tobacco Cessation Counseling
  • Hepatitis C screening, counseling and referral
  • Maternal-Fetal Medicine Referral, if indicated

When we discover a women is struggling with an opioid or other substance use disorder, we view this as an opportunity to break the cycle of trauma and addiction. Our goal is not necessarily to get our patients into recovery; it is to help our patients have the healthiest pregancy possible.

Our goal is even bigger: We want women to understand that they are worthy of care, that they are strong enough to take care of themselves and their child, and that we believe in them and will support them any way we can. This may be the first time in a woman's life she has been given this message. What happens next is powerful and can transform lives for generations. 

We invite you to watch this short video interview with one of our Project CARA nurses to learn how we are changing the conversation around addiction and breaking down barriers to quality care for both moms and their babies. [watch interview]


Our multidisciplinary staff works with the individual and her support team to find a solution and help her reach her pregnancy and substance use goals.

For appointments, please call 828-255-5542 and ask for an appointment with Project CARA. Outside provider referrals, please fax referral to 828-771-5479.

We look forward to serving you!

Carol Coulson, MD, FACOG, MFM Division Director 
Athena Collins, MA
Michelle Bartlet, MA
Marie Gannon, LCAS, LPC
Ann Mann, RN
Nathan Mullins, MD, FACOG  
Ra’Sheena Parker, WHNP-BC
Melinda Ramage, FNP-BC