MORGANTOWN, W.Va. — Approximately one in five babies born in West Virginia is exposed to drugs or alcohol, but a program at West Virginia University is working to keep both babies and mothers healthy.
WVU’s Drug Free Mom and Baby Project — entitled “ACE” (Assisting, Connecting and Encouraging) — serves pregnant women with substance use disorder and helps them achieve a healthy pregnancy.
Cassie Leonard, assistant professor of Obstetrics and Gynecology at WVU’s School of Medicine, said the program has had a tremendous impact since its inception three years ago.
“When you just have those one or two women that have really great success stories, it means everything to you because nobody wants to do this,” Leonard said. “So when they’re able to successfully complete the program, get through the pregnancy and do well, they’re just as happy as you are because that’s all that they want.”
As of October, 84 moms were enrolled in the ACE program, including 10 pregnant women, 17 postpartum women and 34 lost to follow up.
“Part of our program is to actually follow them for two years after they’ve delivered, to keep in contact with them and make sure they’re continuing to get all of the services that they need,” Leonard said. “The problem is, once the baby is born, we have a huge dropoff rate. Either they relapse because they’re no longer pregnant and that incentive is gone, or they’ve had something happen to them. Maybe the baby was taken away and put into foster care. That is another hit to them, so they’re relapsing for that reason.”
While exposure to drugs and alcohol can cause various health problems for babies, one major concern is neonatal abstinence syndrome.
Beginning in October 2016, the West Virginia Perinatal Partnership and Project WATCH collaborated to develop a better way to capture the rates of substance use in pregnancy and neonatal abstinence syndrome (NAS) in the state. Over 10 months of data collection, 13.95 percent showed intrauterine substance exposure, while 5.31 percent had NAS.
“At WVU we keep all of these infants in house for five days, even if they’re not exhibiting any symptoms of withdrawal just to make sure that we don’t miss it and send a baby home too early,” Leonard said.
WVU Hospitals estimates the cost for babies with neonatal abstinence syndrom is about $500 to $700 per day with an average stay of 17 to 18 days, putting the total cost between $9,000 and $12,600.
Leonard said the hospital serves as a first-line of treatment, providing a soothing environment for the babies.
“The lights are kind of dim; it’s quiet; we use swaddling. They eat a little bit more and increased sucking, so they’ll have a pacifier more,” she said. “We try to do more skin to skin with mom and even breastfeeding, if mom’s a good candidate. If she’s in a treatment program and she’s compliant, then we do encourage breast feeding.”
While breast feeding is not encouraged for mothers who are not compliant and are still using off the street, the hospital does try to get those mothers involved in their baby’s recovery.
“If she is willing, while the baby is in the hospital, we’ll try to get her involved, get her to bottle feed her baby and get her into treatment,” Leonard said. “Sometimes that’s where we’re intervening. Sometimes they’ll come in and deliver, and they’ve had no prenatal care or any help thus far.”
Leonard said those mothers are then also enrolled in the ACE program for the postpartum resources.
“We’ll stick with them and encourage them to do everything that they need to do to take care of their child,” she said.
As part of the ACE program, women receive both individual and group counseling in addition to medication assisted treatment.
Leonard said several patients have remarked that the group sessions were the only social contact they had with other individuals, an aspect that is beneficial to recovery.
“They don’t have their parents involved, they don’t have siblings involved, they may not even have friends involved who are not using, and so having that social interaction is so positive to be able to sit down with someone who’ll say, ‘I went through the same thing.'” she said. “That means the world to these women.”
The program’s recovery coach has also helped to provide that kind of peer one-on-one assistance.
“Patients just really gravitate toward her because she has that personal experience with using and has been in recovery now for several years,” Leonard said. “We have found that our patients gravitate to her and want to talk to her just because they know she understands. It’s hard to understand somebody that’s been through what they’ve been through without being through it yourself.”
At the start of the program, 194 participants enrolled during their first trimester, with 80 percent of urine drug screenings returning as positive for something other than what the patient was prescribed.
Those rates decreased to 48 percent by the second trimester and 24 percent by the third trimester, and by the time of delivery, only 21 percent returned as positive for something other than what the patient were prescribed.
Now three years into the ACE program, Leonard is thrilled to see the difference it has made in many women’s lives.
“This is a very gratifying thing to be a part of,” she said. “It’s also very frustrating because we do also have a huge dropout rate too and still a high rate of unintended pregnancy. So we have a lot of work to do, but at least we see that the work we’re doing is making a good effect on these women.”
Leonard said 90 percent of the women who have gone through the program have had an unintended pregnancy.
“This number also shows that we have a lot of work to do in West Virginia for contraceptive services throughout the state, and especially women don’t necessarily have insurance or access,” she said. “We need to make sure all women have access to contraceptive services so they’re not in this situation … That is definitely something that we need to work on in our state.”