Addiction care for pregnant and postpartum women brings experts and lawmakers to VCU event

By Amelia Heymann

Mandie Bishop was struggling with addiction. Already a mom, and learning she was pregnant again, she decided to go to the hospital to get help - and her children were then taken from her.

The separation depleted her motivation. Bishop said she fell into "a dark place," leading to a near-fatal overdose.

"That was seven years ago," said Kathryn Haines, director of policy for the Virginia Interfaith Center for Public Policy. "I could tell you a similar story from a week ago."

Bishop, who found her way to sobriety, did tell her story recently - to a state lawmaker - at an event hosted by Virginia Commonwealth University's Institute for Drug and Alcohol Studies with support from Delegate C.E. "Cliff" Hayes. "First Steps to Healthier Families: Effective Substance Use Policy for Virginia Moms and Babies," which was held Sept. 23 in the Patrick Henry Building, featured medical and academic experts, community organizations, lawmakers and individuals in recovery.

Because of the law's current phrasing, plus the ongoing stigma of addiction, many mothers remain afraid to get help for their substance use disorder. The result has far-reaching consequences and was a focus of the "First Steps" event.

Hayes gave opening remarks at the event, emphasizing the importance of treating mothers struggling with substance use disorder. He said effective solutions are found through workgroups that bring together different perspectives, opinions and ideas.

"We are more effective when varied communities, through creative abrasion, come together to solve problems," Hayes said.

Del. C.E. "Cliff" Hayes (sitting) spoke at the "First Steps to Healthier Families" event, emphasizing the importance of supporting mothers who are struggling with substance use disorder. (Photo by Miño Smith)

James Bacon, community engagement manager for the Institute for Drug and Alcohol Studies, noted that addiction impacts healthcare, housing, societal beliefs and policy. In turn, they are influenced by an outdated model that views addiction as a series of bad choices rather than a disease or issue of brain chemistry.

"Too often, pregnant and postpartum women are unable to access, or afraid to seek, lifesaving medical care and support services," he said.

At the First Steps event, presentations included research that coincides with two General Assembly bills introduced by Sen. Mamie E. Locke and Del. Hayes (SB 133/HB 652), which created a work group to evaluate Virginia's response to parental, prenatal and postnatal substance use. The work group will submit recommendations to the General Assembly on Dec. 1.

Statistics show that 40% of pregnancy-associated deaths are due to overdose, and little funding is directed to preventative measures, according to Caitlin E. Martin, M.D., associate professor in VCU's School of Medicine and director of OB MOTIVATE clinics at VCU Health.

The event also highlighted how early intervention, in addition to helping keep families together, can save taxpayer money. VCU and the Virginia Department of Health partnered to create the Virginia Opioid Cost Data Tool, which shows state costs related to the opioid epidemic. By helping pregnant and postpartum mothers who face addiction, the state can save on costs tied to later interventions such as longer-term treatment, foster care and other expenses.

Comprehensive treatment for substance use disorder can involve an inpatient or outpatient facility, medication and therapy.

"There's a lot of research that shows that when we use a collaborative care model where we integrate women's healthcare and addiction treatments … along with wraparound supports that address social drivers of health, we actually do a really great job in improving outcomes for mom and baby," Martin said.

Roundtable discussions at the event allowed legislators and VCU staff to ask leading experts questions about policy and legislation. (Photo by Miño Smith)

Experts also noted that taking evidence-based medications for addiction during pregnancy or breastfeeding is safe and promotes positive outcomes for moms and babies. The way code is written leads to negative perceptions of these medications, despite multiple professional societies such as the American Society of Addiction Medicine or the American College of Obstetricians and Gynecologists, endorsing their use.

Valerie L'Herrou, deputy director of the Center for Family Advocacy at the Virginia Poverty Law Center, added that children from families receiving substance use treatment and proper recovery support can achieve positive outcomes.

The First Steps event also spotlighted the geographic variation that affects mothers seeking addiction support. Many women drive hours to cities like Richmond and Roanoke to get help, as some localities may fund evidence-based addiction care while adjacent ones may not.

After the event's presentations, roundtable discussions allowed legislators and VCU staff to ask leading experts about scientific research relevant to policy and legislation. This is when Bishop was able to share her story with Sen. David Suetterlein.

"They were wonderful discussions with both practitioners and previously addicted mothers who were able to get the help," the Roanoke lawmaker said. "It was very helpful to have those conversations."