Last June, Dajia Brown embarked on a dangerous phase of life — so dangerous that many in her situation do not survive.
It started when she gave birth to her daughter, Brooklyn, several months after entering treatment for addiction to fentanyl pills. The postpartum period, a tough time for many women, can be particularly challenging for women with opioid use disorder, putting them at high risk of relapse and overdose.
In Massachusetts, according to the state’s analysis of overdose deaths, nearly four in 10 deaths among women who gave birth between 2011 and 2015 were caused by opioid overdoses, compared with two in 10 among women who did not give birth.
Against the odds, Brown has stayed sober and is raising a healthy baby in Somerville, an outcome she attributes to the help she received at a Boston Medical Center clinic established for women like her and their children. But that clinic started only in July, and such programs are few and far between. More commonly, advocates say, new mothers struggling with addiction get little attention.
“We take intensive care of women during pregnancy. Postpartum, we drop them like a hot potato,” said Daisy J. Goodman, a clinical assistant professor at the Dartmouth Institute for Health Policy and Clinical Practice.
In some states, Medicaid benefits for women can end two months after childbirth. Even in Massachusetts, where coverage continues under a generous Medicaid program, new mothers who have struggled with addiction often confront a hostile world alone.
When pregnant, many women stop using drugs to protect the child growing within them, and usually can find programs that help sustain them in treatment, such as Boston Medical Center’s Project RESPECT.
With women motivated and supported, rates of overdose-related deaths drop during the second and third trimesters.
Then the baby comes.
And women new to recovery, who still need treatment and support, have an often-fussy infant calling on them around the clock, while temptations to resume drug use lurk around every corner.
But they don’t find as much help as they did when pregnant — and the overdose death rate soars among women six months to a year after giving birth.
“Now we’re realizing the easiest part is when you’re still pregnant,” said Dr. Kelley A. Saia, Project RESPECT director. “Postpartum, all your resources tend to fall apart.”
That’s why in July Boston Medical Center launched its SOFAR Clinic (Support Our Families through Addiction and Recovery) for patients leaving Project RESPECT.
If you or someone you know has struggled in the past with alcohol or substance abuse and is expecting or has a new baby help them by making sure they have support with local resources, friends and family.