About MAiN

A multidisciplinary, coordinated approach that facilitates collaboration among clinicians caring for opioid-dependent mothers and their newborns.

The MAiN Program
The MAiN Program provides education, support and other resources to mothers using opioids during pregnancy to minimize the risk of health problems for their babies. Our goal is to help each mother enrolled to have a rewarding birth experience, a healthy newborn, and to provide tools for positive parenting, despite struggles against chronic pain, substance use, and/or mental health issues.
The MAiN Model
The MAiN model incorporates an inpatient, multidisciplinary, coordinated approach that facilitates collaboration among clinicians caring for opioid-dependent mothers and their newborns. The MAiN model has been shown to be safe, effective, and cost saving. Each month, Prisma Health Upstate serves an average of 14 substance-exposed infants, and administers MAiN treatment to 2-3 infants.
The MAiN Treatment
Palliative intervention with three key components: Early initiated pharmacological treatment within 24 hours of birth for qualified newborns, rooming in with mother or care in the Level I nursery when mother is not available, combined inpatient stabilization with outpatient medication weaning.

The MAiN Pathway

How It All Began

The History of MAiN

Over the past decade, a clinical team led by Dr. Jennifer Hudson at Prisma Health Upstate has developed, implemented, and evaluated the Managing Abstinence in Newborns (MAiN) model of care providing early pharmacological therapy to otherwise healthy newborns at highest risk for neonatal abstinence syndrome (NAS).

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The Heart Behind It All

Our Core Beliefs

All women deserve a positive birth experience.

Mothers and newborns belong together, with rare exception.

Sudden opioid withdrawal is painful, potentially harmful, and should be prevented.

Health care providers should advocate for the well-being of vulnerable populations.

All patients deserve a primary care medical home.

Meet the Physician Champion

Jennifer Hudson, MD is the Medical Director of Newborn Services at Prisma Health Upstate flagship hospital, Greenville Memorial Hospital. Dr. Hudson received her medical degree from the Medical University of South Carolina in 1997, where she graduated a member of AOA Honor Medical Society.  She completed her Pediatric residency with Greenville Health System (now known as Prisma Health Upstate), receiving the Jackson Award as an intern and the Miracle Maker Award as senior resident.

Dr. Hudson served as Chief Resident for the program and joined faculty in her current position in 2000. She has been honored with numerous awards while at GHS, including the GHS Matthews Outstanding Faculty Teaching Award in 2005 and in 2014, Pediatrician of the Year in 2013, and the Outstanding Faculty Research Award in 2017.  Dr. Hudson’s special academic interests include breastfeeding, newborn medicine, environmental health, and residency curriculum design.  

"If doctors know that a mother is being treated with a long-acting opioid, such as methadone, during pregnancy, then why can't treatment start at birth, before withdrawal begins?"... "I watched babies suffer... and it felt unethical".

- Dr. Hudson

From Thinking to Action

Our Guiding Principles

A majority of NAS cases are associated with maternal supervised opioid replacement therapy and are therefore predictable.
Otherwise healthy newborns chronically exposed to long-acting opioids in late gestation may be presumed opioid-dependent and at high risk for withdrawal.
Opioid-dependent newborns, whether due to fetal or postnatal exposure, should be managed using similar methods, such as anticipatory oral weaning.
Caring for all NAS cases in NICUs will increasingly strain resources needed for other critical neonatal conditions. 
Prolonged hospitalization is associated with high costs and rare but serious safety risks.
Rooming-in promotes maternal-infant bonding and a supportive care environment for treating NAS.
Case management services to develop appropriate plans of safe care are especially beneficial for mothers with substance use disorders and their infants.