People working in pregnancy help, increasingly those in maternity housing, are responding to pregnant women struggling with such addictions through various means, guided by a white paper written by the Maternity Housing Coalition.
“It was written because we were talking to homes and seeing such a high incidence rate [of addiction],” said Valerie Harkins, director of the Maternity Housing Coalition, a project of Heartbeat International.
“At the time, it was a notable increase in conversations with homes experiencing struggles with women who have a history of substance abuse or even currently struggling with maintaining their sobriety,” Harkins said.
The white paper serves as a resource for homes, she said.
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Titled Women in Process: Maternity Housing Considerations for Women Who Experience Addiction, the text showcases what some homes are doing to help pregnant women and those who have given birth and stay in the home who struggle with addiction.
Some of the ideas include partnering with other organizations in the community for detox, treatment and recovery programs; creating short term ‘emergency rooms’ for those seeking treatment; bringing a counselor or therapist to the home; providing random drug testing in the home; and screen for drug use during the intake process.
All of these approaches are workable, Harkins said, however, some more so than others.
Need for help
Ten to 15 years ago, homes could refer pregnant women struggling with addiction to community rehabs and treatment centers. That is no longer the case, she said.
“They would get clean, get stable, and then come to the maternity home,” Harkins said.
“Two things have happened since then,” she said. “Number one – our rate of substance abuse is sky-high in America. Number two – rehabs largely stopped serving pregnant women.”
Many mental hospitals and rehabs stopped serving pregnant women or those over a certain gestation, said Harkins.
“So, we had more women with substance abuse, the drugs themselves are becoming stronger and more deadly, and then we have rehabs that are taking pregnant women less and less,” she said.
Even if the women get into a program, “homes are seeing more and more struggling with their sobriety,” especially after birth of the child, she added.
“Homes felt ill-equipped,” Harkins said. “Whereas we once referred out for these needs, homes are finding ways to give them drug tests, and it’s almost every resident, or every other resident. It kind of became so prevalent that we said, ‘Okay, we have to become equipped to some extent.’”
For example, the paper highlights The LIGHT House in Missouri, which conducts drug tests, and with the first positive test, the woman is required to participate in Alcoholics Anonymous or Narcotics Anonymous, and with the second positive test, the woman is required to join an outpatient rehab program. This ministry employs “a nurse, licensed social workers, and clinical staff,” the white paper states.
“We have all kinds of responses that homes have come to in order to serve these women,” Harkins said.
A home in Ohio, for example, uses Medicated Assisted Therapy (MAT) as part of their program, she said. This is a therapy used for women who experience opioid dependencies, through a doctor’s prescription for either an injection or capsules, to help “wean them off the opioids,” Harkins explained. There’s a strong reason for this.
“Women who were addicted to opioids and then stopped cold-turkey during pregnancy have a greater chance of late-term miscarriage,” she said. “Pregnant women just aren’t capable, biologically, to cold turkey safely off of these drugs.”
She said she is proud of the homes that have embraced such programs.
“We have to do something [to help pregnant women who are addicted],” she stated.
Bethlehem House, located in Omaha, Neb., is another home that is addressing the issues of addictions and sobriety.
“Now we are seeing changes,” Harkins told Pregnancy Help News. “When once we used to be ‘Okay, we can’t provide that service,’ homes are saying, ‘Man, we have no choice but to come up with some level of competency and responsiveness to this because of the high incidence rate,”
The Department of Health Human Services declared the American opioid crisis “a public health emergency” in 2017. And in 2023, Harkins provided training on the topic of addiction and maternity homes during the 2023 Heartbeat International Annual Conference.
Women unique to addiction risk factors
According to the Mayo Clinic, women “have a unique set of risk factors” for opioid addiction.
Women are more likely than men to have long-term pain. Compared with men, women also are more likely to be prescribed opioid medicines, to be given higher doses and to use opioids for longer periods of time. Women also may be more likely than men to become dependent on prescription pain relievers, the clinic says.
Maternity homes are responding to the opioid epidemic and helping women who struggle.
“We’re seeing a variety [of measures taken],” Harkins said. “The main one I’m seeing is that they are incorporating more and more information on day one about substance abuse and sobriety and ensuring that it is a normal conversation in the home and that it’s an on-going conversation in the home.”
Significant increase in U.S. maternity homes
There are 196 maternity homes in the United States that are part of the Maternity Housing Coalition, including ones started and run by pregnancy help centers, Harkins said. New homes are opening soon in Virginia, Indiana, and Texas.
In 2023, Harkins said she saw a 21% increase in maternity housing offerings, and she believes that figure will be close this year as well.
“I would be shocked to not see that increase in 2024,” she said. “We have 54 start-up homes that we’re working with now, and about one-third of those are centers opening homes. There’s lots and lots of interest around that subject.”
The issue of affordable housing is the driving factor, she said.
“More and more women are saying, ‘Housing is so unaffordable,’” Harkins said.
“These women, even if they work fulltime, find it impossible to afford their bills and support themselves,” she said.
Therefore, organizations, including pregnancy centers, are opening maternity homes in their communities.
“It’s the economic factors that are leading centers to realize, ‘More and more of our clients have nowhere to live and it’s not always feasible to send them out to another maternity home,’” Harkins said. “It used to be the centers did not have enough clients with this need. But now centers often report that they have so many clients, they can’t justify NOT opening a home.”
The unaffordable housing situation is taking place “in all states, rural, urban, suburban areas,” she added.
“Women are in crisis, and it is largely economic,” Harkins stated.
Additional factors
Another situation impacting women is the lack of daycare.
“A third of daycare facilities did not open after COVID,” Harkins said.
Additionally, the cost is high if a woman can find childcare.
“It’s about the cost of a mortgage payment now,” she told Pregnancy Help News.
“For our women, in most states, they have a childcare voucher, a subsidy, where they can take the voucher to get help, and that sounds great,” she said. “Now, assuming you can find childcare, one that takes the voucher, the waitlist is locked up for years at a time, there’s so many women needing it. We find over and over a perfect storm, an economic crisis, that’s systemic – it’s truly everywhere.”
Added to that, she said, is the lack of safety on public transit. New York City, for example, now has police stations in their subway stations, Harkins said. Chicago and San Francisco have bus lines but “women are less safe to a significant degree than they used to be,” she stated.
“What we find is every direction a woman turns right now is unsafe, volatile, and grossly unaffordable,” Harkins said. “This has become a perfect storm where women currently say, ‘I can’t have this baby.’ And we have to acknowledge that, and what homes are doing, is saying, ‘We know what she’s saying – she has a point – and we want to help so that it’s not true.’”
Some homes are now also providing childcare to help ease that burden, she said.
Providing for women’s needs
Meeting the needs of women, from helping those who struggle with addiction to providing a safe, caring home environment and affordable childcare, helps not only the mother, but also her child or children.
Tweet This: Meeting the needs of women helps not only the mother, but also her child or children.
“The more that we can provide holistic and specialized services to women, the better off the baby is,” Harkins said. “If mom is okay, baby will be okay, too.”
Editor's note: Heartbeat International manages Pregnancy Help News.
