Along with St. James Healthcare in Butte, Missoula’s Community Medical Center recently received grant money to improve access to quality care for pregnant mothers and their babies.
While the new Montana Healthcare Foundation-funded programs developing across the state rely on standardized, prenatal screening for substance abuse, societal stigma and the fear of Child and Family Services may deter some pregnant women from being honest about their struggles with drug use.
When the Missoulian published an article in February about a Montana Healthcare Foundation report titled “Strategies to Address Perinatal Substance Use Disorders,” the Facebook commenters displayed their disapproval of addicted mothers.
Some of the comments have been removed, the page notes, but some remain.
“I think we should be able to sterilize them. If you care more about doing drugs than the welfare of your baby you don’t really have any business reproducing,” one commenter wrote.
One of the lead doctors for Community Medical Center's developing grant-funded program, Dr. Brad Holbrook, read some of these negative comments.
“These women feel judged because they are judged,” Holbrook said. “They are marginalized and considered the downtrodden of society.”
Holbrook noted that the shame these pregnant women feel can be a fuel to their substance abuse. If they don’t receive treatment because they are ashamed to admit their addiction, they continue on a downward, emotionally-charged spiral, he said.
“Do I think these women should be using while they’re pregnant? Of course not,” Holbrook said. “But they are, so it is my job to help them.”
In Butte, Leslee Chiasson was scared to tell Dr. George Mulcaire-Jones about her addiction to prescription pain medication, because she thought he would judge her. (See related story.)
While she said this admission wasn’t easy, her fears had to do with more than being stigmatized. Chiasson thought that if she admitted to struggling with addiction, the chances of her baby being taken away by Child and Family Services or Child Protective Services would increase.
“At first, I didn’t want to be honest about my addiction. It all comes back to the scary CPS,” Chiasson said. “Telling gives the listener a lot of power.”
St. James Healthcare social worker Joslin Hubbard said there is no guarantee that a pregnant mother won’t lose her baby if she discloses her addiction. However, if a mother takes the right steps to recovery, Hubbard said she’ll be more likely to take her child home.
“What I can tell them is that, if they’re taking a prescribed treatment medication, making appointments, and being honest with us, then I can help advocate for them,” Hubbard said.
However, Child and Family Services does have an obligation to ensure the well-being of children, Hubbard said. The increase in early childhood drug exposure is directly related to the increase of Montana children in foster care.
The number of children in foster care has doubled since 2011, and 64 percent of home removals in 2016 were related to parental substance abuse, according to a 2018 Montana Healthcare Foundation literature brief.
But with the grant-funded programs developing at St. James and other Montana communities, Hubbard said providers can better educate Child and Family Services about addiction treatment along with the rest of the collaborative perinatal team.
“Part of this grant is building better relationships with these service agencies,” Hubbard said. “I communicate with CPS a lot, but we’ll make sure they’re open and aware of the things we’re trying to do with this program.”