The most vulnerable women The Next Door serves are our pregnant clients. These women walk through our doors in active addiction and are in dire need of treatment services for both them and their unborn children. If women don’t get help, there can be serious negative health outcomes for pregnant women and their developing babies, including preterm birth, stillbirth, maternal mortality, and neonatal abstinence syndrome.
Unique Issues for Addiction During Pregnancy
Becca Humphreys, a peer advocate with Strongwell, discusses the unique stressors that come with addiction during pregnancy.
- Physical Stressors – Along with morning sickness, exhaustion, and weight gain, pregnant women can experience lower back and pelvic pain, which is especially challenging for women whose substance use disorder stemmed from treating pain with opioids.
- Hormonal Changes – Fluctuating hormones can create anxiety and depression, adding to mental health problems a woman may already have.
- Contraindicated Medications – Medications taken for anxiety or depression may need to be stopped during pregnancy, leading to a worsening of a woman’s mental health condition.
Signs and Symptoms
There are several signs to look for if you are worried that a pregnant woman you know or love is struggling with a substance use disorder.
- Isolation – Pregnancy is a time when many women want to be around loved ones. However, a woman with a substance use disorder may isolate herself to keep her secret.
- Avoiding OB appointments – A woman may avoid medical care fearing the doctor will discover her substance use disorder and judge her.
- Lack of weight gain – A woman may not gain weight like in a typical pregnancy. She may even experience weight loss.
- Erratic Behaviors – Addiction can lead to erratic behavior, poor hygiene, aggression, and other unpredictable emotions.
Barriers to Seeking Treatment
Humphreys says a primary barrier for pregnant women is knowing where to go to find help. “There are not a lot of resources. There is also the stigma around pregnancy, addiction, and concerns with the Department of Children’s Services. It is difficult to admit something that may take your child from you.”
There is also a lack of OBGYNs who will take on women with substance use disorders as patients. A woman is often referred to a high-risk OBGYN and may lack insurance to pay for the extra cost.
Detoxing during pregnancy is another barrier. A pregnant woman detoxing from opioids can suffer dehydration, which can cause contractions resulting in pre-term labor. Detoxing from alcohol and benzodiazepines can actually be deadly for both mom and baby.
“To try to hunker down and detox on your own seems reasonable,” says Humphreys. “But, I tell people they may get through the worst of withdrawals, but if you are not actively supported and not seeking recovery support, your odds of staying sober decrease phenomenally.”
The stigma also prevents women from seeking help. Humphreys recalls being in active addiction with her second pregnancy.
“You have so much shame and guilt as a mother” says Humphrey. “But we are talking about substances that you are physically and mentally dependent on. It’s not whether about you care and love that baby. Just admitting your addiction can be really difficult.”
Treatment Options that Work
Advances in addiction treatment now present pregnant women with several options.
- Medication Assisted Treatment involves a prescribed medication that is less harmful to the baby but helps with drug cravings and withdrawal symptoms.
- Working a recovery plan and receiving behavioral health care for co-occurring conditions increases the women’s chance of success.
- Many women in addiction don’t seek basic health care, and these visits increase in importance during pregnancy so doctors can monitor the health of mother and baby.
- If a woman knows she can seek help and have a team of doctors and treatment professionals aid her recovery without judgement, she is more likely to seek help.
Humphreys says if you don’t know where to turn, the first call is to a high-risk OB in your area. Also, The Next Door accepts pregnant women up to 38 week gestation, and they are given priority in admissions.