Perinatal substance use disorders, and all of the associated sequelae, continue to be a national health crisis that is further impacted by shifts in access to obstetrical care, particularly in rural areas. Opioid Use Disorder (OUD) specifically presents as a medical condition for which evidence‐based guidelines support the use of medication treatment for opioid use disorder (MOUD) in the form of Methadone or Buprenorphine for both non‐pregnant and pregnant women. However, the overall rates of access for those treatment modalities remain sparse. There is a public call to increase access to MOUD in the pregnant population affected by OUD. This article discusses the history of the Advanced Practice Registered Nurse (APRN) and how across legislative differences, these professionals are perfectly positioned to answer this call.