Community, St. Pat’s to develop program for pregnant women fighting substance use

The number of children removed from their parents' care in Missoula County has doubled over the last five years, a problem some experts trace to perinatal opioid exposure and other substance abuse disorders.

The lack of addiction services and access to treatment for low-income pregnant women doesn't help.

Community Medical Center and Providence St. Patrick Hospital will split a $300,000 grant from the Montana Health Care Foundation to develop a program aimed at improving care for pregnant women who struggle with perinatal drug and alcohol use.

The two Missoula hospitals announced the grant this week.

“As physicians who care for mothers and their newborns, we are committed to help mothers receive the supportive treatment for opioid dependence before and after delivery,” said Dr. Deborah Reed-Thurston, a neonatologist at Providence. “We're confident that building this program will give women the tools, resources and hope for themselves, their baby and their families.”

Women who use opioids while pregnant often affect their infants, who are more likely to be delivered early at a low birth weight. After birth, Reed-Thurston said, many experience neonatal abstinence syndrome, or opioid withdrawal.

Symptoms include crying, high muscle tone and tremors, along with feeding difficulties, weight loss and seizures. Across the U.S., an infant is born every 25 minutes with withdrawal symptoms due to opioid exposure.

But in Missoula County, health care experts believe many pregnant women with substance use disorders don't seek prenatal medical care. The reasons are many, ranging from stigma to economics to a lack of access to affordable prevention and treatment services.

“It's important to not vilify pregnant women and mothers with substance use disorders,” said Dr. Bonnie Stephens, a neonatologist and pediatrician with Community Medical Center. “Moms need treatment, and they need to be supported so they can recover from addiction and care for their babies.”

Substance use has had an impact on Missoula families, often resulting in the removal of children from their parents’ care. The number of children in foster care in Missoula County has doubled from 124 in 2012 to 268 in 2016, according to the Montana Health Care Foundation.

With an eye on improving access and treatment, the foundation awarded its latest grant as part of its Solving Perinatal Drug and Alcohol Use initiative, a collaboration with the Montana Department of Public Health and Human Services.

Dr. Bradley Holbrook, a maternal fetal medicine physician at Community, said the joint program will help develop a number of treatment methods, such as methadone during pregnancy, which can help prevent both maternal and fetal withdrawal.

“Prescribed methadone during pregnancy improves prenatal care, reduces illicit drug use, and minimizes the risk of fetal in utero withdrawal,” he said. “When paired with counseling, it has been shown to more than triple the chance of successful recovery.”