Substance use in pregnancy has been increasing for the past decade, and New Mexico has one of the highest rates of neonatal opioid withdrawal syndrome (NOWS) of any state in the nation. Many states have taken punitive approaches to this issue, criminalizing substance use in pregnancy, which has not had the desired effect of decreasing substance use and in fact has been shown to lead to worse outcomes including lower rates of prenatal care, increased preterm birth, and fewer mothers and babies getting the treatment and support they need.