“Addiction is a monster, and it will take anybody down—it doesn’t matter if you’re pregnant”

Healthcare professionals are working fervently to help mothers who are battling opioid addiction.

Embroidery: Emily Beaton; photo: Stocksy

Hailey Fennell vividly remembers the day she got pregnant with her third baby: It was the first time she used crystal meth.

Fennell, who lives in Belleville, Ont., had turned to the addictive street drug because it offered a cheap high. At that point, she didn’t feel like she had much left to lose. Fennell had suffered through years of bad boyfriends, abuse and a volatile relationship with her mother. To get through all the trauma, she relied on drugs—especially opioids like heroin and morphine—to numb herself. Three years ago, when she came home one day to find the love of her life—and the father of her second child—dead from a drug overdose, she wanted to blur her reality even more.

When she got pregnant for the third time, it was an accident, but it provided a much-needed wakeup call.

She had used drugs throughout her second pregnancy and was horrified by the withdrawal symptoms that her infant son experienced as a result. His cry was high pitched and he was writhing in pain, so doctors put the infant on morphine when he was just five days old. Still, he threw up constantly and, by the time he was two months old, had only managed to gain half a pound since birth, bringing him up to eight pounds. “He was a little skeleton,” recalls Fennell. “He was starving to death.” As soon as a dollar-store pregnancy test confirmed her hunch, she marched herself to a methadone clinic, where they gave her another test and started her on a regimen of opioid-replacement therapy.

Having already lost custody of her first two sons, Fennell feared losing her third child. She was determined to spare this baby the same pain.

“The disease of addiction is a monster, and it will take anybody down in its path,” she says. “It doesn’t matter if you’re pregnant.” Fennell was determined to get clean for her new baby and transform herself into the responsible mother she wanted to be, but it wouldn’t be easy.

Opioid addiction is one of the most powerful addictions. Available in prescription pills, such as Percocet, or sold on the street as heroin or fentanyl, opioids are designed to block physical pain and depression by flooding the brain with feelings of contentment, happiness and even euphoria. For women who have suffered trauma as children or adults, opioids are the common drug of choice and a quick path to addiction. The number of people who are dependent on them has ballooned over the past few years, and doctors have declared opioid abuse to be a national health crisis in Canada. Canadians are the second-highest per-capita consumers of opioids in the world, next to the United States. Over the past 25 years, the number of deaths attributed to opioid-related causes has increased fourfold in Ontario.

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In this epidemic, babies born to mothers who are dependent on opioids are particularly vulnerable. Adapting to the challenge of a new baby—decoding cries and feeding while physically recovering from pregnancy and birth—is a strain for many new mothers but even more so for those who are fighting addiction.

Many studies show that children who are exposed to trauma risk adverse educational and mental health outcomes that can have a lifelong impact. These outcomes range from learning and memory difficulties and trouble regulating emotions to increased anger and elevated emotional and physiological responses to stress. From family doctors and obstetricians to nurses and social workers, healthcare workers are trying to find innovative approaches that will not only start mom-and-baby pairs off with a strong bond but also set them on stable pathways. Their hope is to break the intergenerational cycle of trauma and limit the repetitive damage caused by opioid addiction.

The power of mindfulness
Diane J. Abatemarco, director of Maternal Addiction Treatment Education & Research (MATER) at Thomas Jefferson University in Philadelphia, has been studying the effects of mindfulness on these mothers. As part of her research, Abatemarco tests the impact of what she calls “trauma-informed mindfulness-based parenting interventions” on mothers on who are being treated for opioid addictions with methadone or buprenorphine. “Mindfulness creates the ability to be in the moment and be responsive, not reactive,” says Abatemarco. She’s found that many women who have suffered trauma and addiction consider their children’s crying or insistence on something as deliberate provocations. Part of the therapy they receive involves learning that their children are not crying to “push their buttons.”

The results of Abatemarco’s latest study, published last month in the Journal of Addiction Medicine, show that teaching mindfulness techniques to mothers in opioid treatment can measurably improve their quality of parenting. During 12-week sessions, 160 mothers participated in a weekly group therapy session staffed by a trauma-informed mindfulness-based stress reduction teacher and a clinician.

In the first class, the women were taught techniques to help them focus on their breathing and “be in the moment.” The mothers learned how to channel those techniques and apply them to a variety of real-life scenarios so that they could face situations with confidence instead of looking for a means of escape. The goal was to ward off stress, which can trigger the impulse to use drugs, and learn how to show compassion to themselves.

Abatemarco used the study to ask the question “Every time they’re in a stressful situation, could they come back to their breath as their anchor, no matter what the situation is, and just breathe? Could that open up a space for different decisions?” Her team measured marked improvements in both stress levels and parenting quality and anecdotally noted increased attachment levels. And it didn’t take 12 weeks to get there: Improvements were noticeable by the halfway point of the study. By then, the mothers had perceived their babies’ cries as signs of need rather than a personal affront. They were noting their babies’ smiles and laughs and giving them their full attention.

The takeaway, says Abatemarco, is that a  a 10-minute daily practice can improve parenting outcomes and offer hope for changing the intergenerational trajectory of trauma.

“Mindfulness helps them access their emotions,” says Abatemarco of her patients. “When they’re using heroin or other opioids, they’re self-medicating because of all the trauma they had to deal with as children and adults. They really are on the road to becoming improved mothers.”

Ending the cycle of trauma
Dolores Turner, a social worker at the Belleville and Quinte West Community Health Centre, sees the same thing in her practice. She helps run a weekly support group for mothers who are battling addiction, including Fennell. “I don’t think anybody says, ‘I want to be a crappy parent,’” she explains. “People always want to do what’s best for themselves, their families and their friends.” But traumas in their lives lead them down another path.

One new treatment centre in the works in Kingston, Ont., is aiming to end the cycle of trauma. Adam Newman, a family physician and addiction treatment specialist in Kingston, is cofounder of an organization that is working to build the Kingston House of Recovery for Women and Children, an addiction treatment centre that will house women and their children, from newborn through six years of age. There are only a handful of centres like it in Canada, including the renowned Portage Programme Mère-Enfant in Montreal.

The goal, says Newman, is to create a “therapeutic community” where up to 25 women can live for months at a time if needed. They would not only receive treatment but also learn parenting and life skills to set their families on a stable track—and stay under one roof. “We’ve all seen innumerable cases of women who deal with addiction, haven’t had any services offered to them and have lost custody of their children,” says Newman. “It’s heartbreaking to be in the delivery room after you’ve seen the miracle of childbirth and the children’s aid workers open the door and take the baby.”

The concept of the treatment centre, which would be staffed with nurses, social workers and other healthcare workers, would allow new mothers to transfer directly from the hospital to continue their recovery. “We really wish we had a place where women could go to continue to be looked after, supported, encouraged and observed if necessary,” says Newman.

However, construction of the new centre is probably still a few years away. Its first donation was only received last month. In the meantime, people who support mothers who are battling opioid addictions are doing their best to create communities that accept and assist them.

For Fennell, having access to compassionate help and belonging to a support group of people who are going through similar experiences has literally been a lifeline. Her newest baby, Ryerson, didn’t experience withdrawal. He is now eight months old and thriving; Fennell has managed to both keep him and keep clean. “I’ve never trusted anybody like this before,” she says. “I know that I’m clean and I just see life a lot differently. I don’t want to go out and party or use; I just want to be a mom.”

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