Nurturing expectant moms who have substance use disorders

When Tia Renner became pregnant in early 2021, she was overwhelmed with fear and doubt. She lived in a tent in Portland, Oregon, and there were days when she didn't have enough to eat. She also struggled to get sober.

Then one of her physicians at Kaiser Permanente referred her to a maternity program for women with addiction. Project Nurture helped her change her life. She moved in with her parents and got substance-use counseling, a job, and a car. She's sober, too, and deeply grateful for all the help she's received.

“I'm really doing well now,” she said. “I never, ever dreamed that I could do the things I'm doing now.”

Pregnancy and substance abuse

The Project Nurture was started in 2018 and helps guide expectant moms and new mothers who have substance use disorders.

The program provides virtual and in-person addiction treatment and maternity care from a team that includes an ob-gyn, a family physician, addiction counselors, and 2 weekly support group meetings.

Project Nurture also offers help from peer support specialists — women who have overcome their own substance use while pregnant.

Women who have or are recovering from substance use disorders face a grim stigma from some members of society who believe they don’t have the tools to be good parents. This withering judgment often leaves them too ashamed to seek prenatal treatment or help with their substance use, especially if they are actively using substances.

An incentive for sobriety

These women face a difficult path to motherhood. But motherhood is a powerful incentive to give up drugs and alcohol, said Autumn Davidson, MD, the project lead for Project Nurture at Kaiser Permanente in Oregon.

“People who are actively using have a fairly hard time obtaining sobriety until they are parents,” Dr. Davidson said. “Often, once their babies are born, they find themselves more motivated to stop using.”

The program is proven to give mothers and their babies a healthy start. A Project Nurture research study conducted in Portland shows that, compared to moms with substance use disorders who receive standard care, Project Nurture moms have reduced odds of preterm labor and lower cesarean section rates. Infants in the program were also less likely to need additional care.

But one of the most important benefits for Renner was the welcoming and upbeat attitudes of the people caring for her during her pregnancy. She was especially grateful for Dr. Davidson’s support.

“What made the biggest difference for me was that she never made me feel ‘less than’ anybody else,” Renner said. “Nobody else was doing that for me. Nobody else was being encouraging or telling me I could get sober and I could make it through.”