Labor of Love

An Open Door for Pregnant Women Battling Addiction

The miracle of pregnancy is life-changing, but no more so than for women with addiction. Faced with a medical world that can be judgmental, they often encounter potentially crushing challenges for themselves and their babies. Drugs have altered these pregnant women’s brain chemistry, often affecting their coping skills, the ability to feel joy and appreciate life, and, for most, their support systems.

But this time in life also opens a door.

“Pregnancy changes things for a mom, and we need to be poised to offer an opportunity for women to make those changes with us,” said Melissa Sherman, MD, FACOG, who runs a unique grant-funded program at Beverly Hospital that offers a comprehensive set of medical, emotional and social supports for women with addiction. The program, funded by both private and public sources, is called Compass, and is a site for the statewide Moms Do Care initiative.

Women who become part of the program are in all different stages of recovery but have much in common, including a very real fear that their babies will be taken from them at birth. “We need to think about addiction as a medical disease,” Dr. Sherman said. “A disease that is very treatable. All our clients have the capacity to change and recover and to parent their children. Our job is to offer the opportunity for change and support them on their recovery journey.”

A tailored approach
Because most people begin using substances following a trauma they have suffered in life, these moms need a trauma-informed space with nonjudgmental medical staff and recovery coaches — and most importantly, women who have shared their experiences. All are intrinsic elements of Compass/Moms Do Care program at Beverly Hospital, which includes training for hospital staff to help them change their attitudes toward women with addiction so that the medical environment can be less judgmental.

“When I first found the program, I was trying to get clean and feeling so guilty about using and being pregnant, but they made me feel like I could open up and be free of all this,” explained Chelsey, a college graduate who grew up in Gloucester. “When I joined, I gained a peer mom who I talked to every day, the social worker who is amazing, and I saw a therapist throughout my pregnancy. I could get all of this in one day. I just had to go to work late one day. I wouldn’t have been able to get all that support all in one place, all tied up in a neat package. It’s exactly what I needed.” Chelsey is now in recovery and the mother of a healthy 1-year-old boy.

The Compass program includes prenatal care, medication-assisted treatment for addiction, “peer mom” recovery coaches and behavioral and/or psychiatric care. A key element of Compass/Moms Do Care is its structured support group made up of other women in the program and “graduates” who continue to work on their sobriety as mothers of young children. Pregnant women attend the program weekly, with all appointments and the support group grouped together so that there is minimal disruption to the women’s schedules. Transportation is provided. The program’s social worker connects the moms with community resources and helps them manage their cases with the Massachusetts Department of Children & Families (DCF).

A crucial need
Dr. Sherman and Nicole Sczekan, CNM, a midwife whose daughter had lived with addiction in pregnancy, initiated the program at Beverly Hospital in February 2017. They modeled it after the Moms in Recovery program at Dartmouth-Hitchcock Medical Center. They initially received two years of funding through the Health Policy Commission Neonatal Abstinence Syndrome Initiative, which concluded in July 2019, and have received an additional year of funding through the Bureau of Substance Addiction Services and the Massachusetts Department of Public Health as a Moms Do Care site.

The Women’s Fund of the Essex County Community Foundation recently has partnered with Beverly Hospital to provide a $15,000 grant to Compass/Moms Do Care. This grant substantially supports the social and educational goals of the program, including logistics support such as funding for transportation to and from Beverly Hospital for participants. 

The goal of the Moms Do Care initiative is to improve access to care and outcomes for pregnant and parenting women with a history of substance use.  The crucial link in this model of care is the peer recovery coach, in this case women with lived experience of addiction and parenting. It is just one way that Beverly Hospital responds to the needs of the community.

As peer recovery moms, Christina Keane and Cieara McManus have no typical days in their challenging positions. They bring the shared experience of addiction and their success as mothers of healthy, happy children — in addition to their expertise as recovery coaches. “Over time, you start to see the moms’ walls come down,” said Christina. “They start off in the frame of mind that they don’t think they have the ability to do anything. Then they slowly get motivated to take care of themselves. Eventually you see a sense of joy, that they finally feel that their lives are coming together. And they’re ready to dive into motherhood.”

Currently, the program serves pregnant and parenting women through their babies’ first birthdays. “Six to 12 months after delivery is when moms have the highest risk of relapse,” said Dr. Sherman. “We work closely with them, and we want to keep them inspired. Here they get to know women who have been sober for more than 10 years, who are stable and doing well in their recovery. Even after the first year, moms know they can come back to the support group or call us if they need help.”



Success and next steps
To date, her team has served 75 women through this lifesaving program, receiving about four referrals per month from physicians, emergency rooms, and social service agencies. Based on current enrollment, Dr. Sherman expects to serve a total of 105 women and their newborns over the next three years. Results from the first two years of the program prove that Dr. Sherman and her team are improving the lives and health of the moms and babies. They have seen a drastic reduction in the length of babies’ stays in both the neonatal unit and for treatment of withdrawal symptoms. More than three quarters of moms remain engaged in the program for a full year postpartum and retain primary custody of their babies.

Dr. Sherman is seeking funding in addition to the current state grant so that she can expand the program’s reach and continue women’s services beyond the first birthday. “We have created a unique, woman-centered, trauma-informed recovery community on the North Shore. The first three years of life are crucial for early child development and it is our goal to continue our mothers’ support and expand our parenting support during early childhood.”

Want to help?

Beverly Hospital is seeking expanded financial support for Compass/Moms Do Care. You can make a gift here. In the gift designation area, please check “other” and type in “Moms Do Care.” For more information, contact Rebecca Imperiali at 978-236-1624.