Clinic combines pregnancy care and addiction help
Pregnant women struggling with addiction are often too ashamed and scared to tell their doctors about their drug and alcohol use.
The Oasis Center of the Rogue Valley in Medford is trying to change that by offering supportive, stigma-free prenatal care plus addiction help.
“One of the biggest barriers for women who have substance use disorder who find out that they are pregnant is stigma and shame,” said Dr. Kerri Hecox, medical director and founder of the Oasis Center.
Women are much more likely to talk openly about their addiction issues at the Oasis Center.
That’s a dramatic change from what Hillary Handelsman often sees at other prenatal care providers. A nurse practitioner and certified nurse midwife, Handelsman is on the Oasis team and has provided care in a variety of Rogue Valley settings.
She remembers one woman who sought care through another prenatal provider. The woman was a heavy, daily user of heroin.
"They said, 'Do you use drugs?' She said, 'Nope.' And they moved right on. It's a huge, huge miss in someone's life to miss that they're struggling with addiction. It's the biggest thing that could be missed. It becomes so central to someone's life when they're really wrapped up in their addiction and they're struggling," Handelsman said.
She said addiction typically affects the health of a woman and her baby, her relationships, her housing and job stability and her ability to be open with her doctor.
"It's such a huge miss that you can't really take care of that person. They're not telling you the most important piece of what's going on in their life right then," Handelsman said.
The Oasis Center has been offering primary care combined with addiction treatment and recovery support for more than two years.
The center received a $600,000 grant from the state to offer combined prenatal, addiction and recovery care for the next three years. The pilot Nurture Oregon program at the center kicked off in March and has built up to 25 women plus their infants.
Statewide, eight locations are part of the pilot program, Hecox said.
She’s tracking results to see if the Oasis Center can reduce medical problems, like babies born too soon or at a low birth weight.
Babies born to moms struggling with addiction, and even those on the road to recovery, can wind up needing expensive care in hospital neonatal intensive care programs.
Hecox hopes she can show the program is cost-effective and worthy of long-term support from the state.
She also wants to reduce the suffering of moms and babies.
Hecox can prescribe medication that eases the symptoms of withdrawal from opioids like oxycodone pain pills and heroin.
Soon after people start taking opioids, they begin to experience severe withdrawal symptoms like pain, cramps, diarrhea, vomiting, nausea, insomnia, anxiety and overwhelming cravings when they aren’t using. Their addiction turns into a relentless search to find more drugs to avoid getting sick.
Handelsman remembers one woman who had to give birth while going through withdrawal.
"Right after her delivery, she was so driven by her addiction to not feel so sick, that she left her baby in the hospital to go out and find more heroin," Handelsman said.
The woman wanted to be a loving, caring parent, but she hadn’t received addiction help and medication to help manage withdrawal symptoms, Handelsman said.
Women who haven’t sought care for their substance use often get “outed” at the hospital through drug testing when they come to give birth.
Oregon Department of Human Services child welfare workers have to get involved, and a judgment has to be made about whether the new mom can safely parent her baby, Handelsman said.
"Right in the moment where they've given birth and they're most vulnerable and they have this newborn baby who needs them right now, everything crashes down," she said.
Babies can wind up in foster care or be sent to live with relatives.
Babies born addicted to drugs can go through the same withdrawal symptoms as their moms. The pain and discomfort makes them cry, and they have trouble eating and sleeping. Sleeping for even one hour at a time is a major achievement for a baby going through withdrawal.
That means a new mom or anyone else caring for a newborn baby faces is exhausted and frustrated, Handelsman said.
“When you can’t console your baby and it’s going on and on for days and you’re struggling with your own addiction, it’s totally overwhelming and unsafe,” she said.
Hecox said babies who go through withdrawal are at greater risk for abuse and neglect. Mothers face a higher risk of post-partum depression.
Early intervention during pregnancy can make a world of difference, putting women on the path to recovery before they give birth.
Hecox said the Oasis Center provides wrap-around care to help before, during and after birth.
"We're really excited about this program,“ she said. ”We have a peer mentor and a pediatrician and also a mental health therapist who's working with us. We're really trying to wrap around stabilization care for women and families so that these families have a chance at a bright future.“
Oasis Center Peer Support Specialist Jillian Mahon knows what it’s like to struggle with addiction and motherhood.
During an eight-year fight with addiction, she had to give her daughter up to foster care.
When she found out she was pregnant again, she got care through Hecox and gave birth to her son while clean and sober. He’s now a 2-year-old, and Mahon has regained custody of her daughter.
Through her job as a peer support specialist, Mahon wants to show people there is hope.
“I really think it's important because we've been there and we've walked through it and we're succeeding in life,” she said. “For people to be able to see that, it gives them hope. When you have addiction you lose hope. Seeing someone who's walked a similar life path as you and come out on the other side is life-changing.”
In addition to emotional support and mentorship, Mahon can help families access resources like housing, food, clothing and other needs.
Also a doula-in-training, Mahon will be able to meet with expectant moms before they give birth, lend them support in the hospital and provide follow-up visits.
She recently helped a mom who gave birth to twins. Mahon said the woman has grown and become self-sufficient, and is a great mom to her children.
“It’s just been incredible to watch the transformation that took place in her,” Mahon said.
For more information about the Oasis Center, call 541-200-1530 or visit oasiscenterroguevalley.org.