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Our Journey
Radical Love.   Bodily Autonomy.  Common Sense Solutions.
Who We Are

Welcome! We are humbled and honored to be alongside you on your journey through pregnancy and parenting. Whether you are researching for yourself, for a partner, or family member - we are happy you're here.


For some of us, the news of a pregnancy is welcomed and exciting. For others, not so much. Whether a pregnancy is planned or unplanned... desired or unwanted... it always brings up complicated emotions. A certain level of ambivalence, worry, and stress is normal - and expected. It takes time to sort things out.


The good news is that you have come to the right place! We are people and parents like you. We have our own lived experience and we've been honored to have others share their experience with us. You are one of these experts. Without you, your knowledge, insight, and expertise we could not exist.

At APHR we are devoted to building community of parenting and pregnant people who use drugs and parenting and pregnant people with lived experience of drug use. In order do this effectively,  we have chosen to be intentional as we build our organization and our community.


At APHR there is no differentiation between "peers" and "staff." We approach our work through lenses of equity and inclusion to ensure that we stop perpetuating the systems of structural violence and gatekeeping that have tried to limit us. We create and curate educational content,  products (graphic design), presentations, and trainings. The information and resources that we furnish folx who come to us are informed and created by our stakeholders and community. Our programs are developed by us, for us

We are passionately committed to addressing perinatal substance use through a reproductive and social justice lens.


We  believe that health literacy lays the foundation for trusting patient-provider relationships and ultimately improves long-term outcomes.


Our collaborative approach to consulting provides a fresh framework for multi-disciplinary, critical analysis of the most current research. Our leadership team has decades of collective experience in:

grass roots advocacy and activism

community organizing

health education




early childhood education


disability rights

clinical social work

birth work

harm reduction

special education

syringe exchange

and of course,  parenting.

Our History

The seeds of our partnership were planted in 2015 when the National Advocates for Pregnant Women partnered with the National Perinatal Association to host the symposium, "Pregnant Women, Drug Use, and NAS: Experts Share Science & Strategies that Help Women, Babies, and Families." Our partnership matured during the fall of 2016 when, with the support and leadership of the NPA, mutli-disciplinary workgroups were created. The goal was to create comprehensive, evidence- based guidelines for interdisciplinary perinatal community. One of our proudest achievements was organizing a workgroup of parents tasked with creating a family toolkit. Another was our position statement on Perinatal Substance Use. And finally, a three-day conference entitled, "Perinatal Substance Use: Evidence-Based Solutions and Support for the Family." As we worked to accomplish more,  it became apparent how gatekeeping, information hoarding, and the historic lack of trust that can exist between medical providers and people who use drugs can create barriers. 


We wanted to promote the idea that equitable information sharing empowers parents and providers to create and build collaborative models of care.

It was here that the Academy of Perinatal Harm Reduction was conceived.

What We Know

We know that public health is influenced by many of the intersections that impact all drug users of reproductive age. Our diverse backgrounds reflect those intersections and inform our products. Those who choose to work with this population often have nothing but the best of intentions. Unfortunately, many do not realize how their work inadvertently upholds systems of structural violence. Draconian policies that are designed to improve outcomes for substance exposed children are the same policies that perpetuate the lasting harms of family separation.


We know that the voices of our community have been marginalized when our work should have been celebrated. Healthy equity is founded on the belief that pregnant and parenting people and people with lived experience of substance use can radically transform institutions and improve care. That is why we consult with our community on content development, empower them to create programs, and employ them in positions of leadership.

We know that access to high-quality, trauma-informed prenatal care is the most important factor when it comes to decreasing mortality and improving health outcomes. We utilize our existing networks of experts to educate families and service providers on evidence-based best practice.  The current legal and cultural landscape continues to be a barrier to improved outcomes. Stigma and fear of legal repercussions keep pregnant people who use drugs from accessing that care.

We know that for many, pregnancy can be an opportunity to access services and make lasting behavioral changes. Service providers can play a powerful role as stewards of renewal and recovery. (As defined by the participant.) 


We know that structural and institutional violence have stripped away agency from our communities and determined their fates. These people are our neighbors, our siblings, our coworkers, our parents - and even ourselves. If substance use in pregnancy is more typical than many of us have believed, then it is high time we begin having honest conversations about the conditions that make that possible, and how we can reduce harm on both the macro and micro levels.


Erika Goyer

Erika believes that everyone should have the information they need to make informed decisions. Erika asks too many questions and wants to see your evidence. She says amazing things on the regular. Next time she does, we will put it here.


Ria Tsinas

Ria works tirelessly to push back on antiquated narratives about drug use and parenting.


Joelle Puccio

Joelle became passionate about advocating for people who use drugs after realizing that everything they had been taught about drugs from childhood through nursing school was wrong.

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