For pregnant people with Substance Use Disorder (SUD), multi-sectoral and collaborative systems of care are central to improving pregnancy, birth, health, and child welfare outcomes. Despite a growing public health concern, evidence from real-life applications are still sparse. In partnership with a community-based collaborative perinatal SUD program, this research uses a multi-method approach to examine facilitators and barriers to program-based recovery and assess child out-of-home placement and birth outcomes. Findings will inform the public health approach to supporting pregnant people with SUD.