Mississippi healthcare providers work to reduce overdoses linked to maternal deaths

By Sophia Paffenroth | Originally published by Mississippi Today

More than 100 Mississippi healthcare providers gathered Wednesday to confront a growing challenge: how to better support pregnant and postpartum mothers struggling with substance use. 

Nurses, doctors, counselors and social workers explored treatment approaches that prioritize rehabilitation, keeping mothers with their babies and replacing punitive measures with care, on Wednesday. The conference was organized by Mississippi Public Health Institute, a nonprofit that develops projects to enhance public and mental health, and CHAMP4Moms, a mental health referral service at the University of Mississippi Medical Center for providers who treat mothers. 

Following a national trend, overdose has become a leading and rapidly increasing cause of maternal death in Mississippi, one of the most dangerous states for giving birth. Mississippi is one of 16 states where people are arrested for reasons related to their pregnancy. Most of these arrests stem from substance use allegations. 

Unlike many of the other states, Mississippi does not have mandated reporting laws, meaning providers don’t have to test or report women for drug use. Mississippi also does not have fetal personhood laws, so drug use during pregnancy isn’t legally considered child abuse. But that hasn’t stopped prosecutors from doling out 20-year prison sentences to Mississippi mothers who are struggling with addiction. 

Drug testing in hospitals often does not lead to safer conditions, explained Dr. Mishka Terplan, an OB-GYN board certified in addiction medicine who has helped develop federal guidelines for treating opioid use during pregnancy. Providers regularly perform these tests for moral reasons rather than clinical ones, Terplan said. Positive drug tests often result in officials separating mother and infant, which can have devastating effects, he said. 

“We have this assumption that somehow the best way for someone to achieve recovery is to do it separated from their child. And only once they’ve achieved that will we allow for reunification,” Terplan told Mississippi Today. “I think that that’s philosophically and ethically backwards.” 

For many people, motherhood can open a “window of opportunity” for behavioral change, Terplan explained. Parenthood can make something as difficult as recovery feel possible for the first time. Too often, Terplan said, babies are taken away before mothers can seize that moment. 

These separations are nothing new. In 2015, Joanne Shedd’s newborn son was taken away from her because of her methamphetamine use. At the time, she said, she grieved that loss as if he had died. Shedd later enrolled in Fairland, an addiction treatment center in Tutwiler. 

A month after arriving at the center, Shedd said, she was reunited with her son. Looking back, she counts herself as lucky. The kindness of the hospital nurses who helped deliver her son got her through that first month postpartum, she said. They took photos of her with her son during their limited time bonding, one of which she printed and kept on her bedroom mirror. 

“That was my motivation when I wanted to give up,” Shedd told Mississippi Today. 

‘We can do better’

Mothers using drugs who lose custody of their children in the U.S. are more likely to return to drug use and experience overdose and worsened mental health, research shows. Mental health conditions is the most common complication of pregnancy. Research estimates 75% of those conditions go undiagnosed, which has fatal consequences and goes against medical standards, experts say. 

A night-and-day difference exists between how providers treat patients experiencing medical emergencies versus those enduring mental health emergencies, said Utsav Nandi, associate director of research at the University of Mississippi Medical Center’s Department of Emergency Medicine. For example, during a heart attack, a medical team works to stabilize the patient and provide continuous care until providers know the patient is safe and will remain so after leaving the hospital. 

“Yet for something like overdose, when someone overdoses and dies and is then revived, the best we can do is ‘Hey, here’s a phone number, and don’t do drugs,’” Nandi said. “We can do better.”

Stigma poses the biggest barrier to recovery facing those with substance use, experts said Wednesday. Instead, providers can educate themselves and reimagine the infant’s health as intertwined with the mother’s.

Since the U.S. Supreme Court overturned the constitutional right to abortion in 2022, political language has pitted the rights and health of the fetus against those of the mother, Terplan said. In reality, they exist, thrive and suffer together, Terplan said.

In 2023, UMMC launched a phone line, called CHAMP4Moms, that Mississippi healthcare providers can call for guidance on screening, diagnosing and treating a pregnant person or new mother who may have unaddressed mental health needs. Providers can get guidance in real time from reproductive psychologists and psychiatrists in and out of state. 

Keeping families together not only makes caregivers happy, speakers stressed. It also saves babies. Infants who are separated from parents often face severe lifelong health and psychological damage due to that trauma. 

Along with reducing stigma, keeping families together is among the best ways to improve outcomes for those seeking recovery, Brenda Foster, the lead nurse navigator for the Opioid and Substance Use Programs at the Mississippi State Department of Health, said during the conference. Foster has over 13 years of experience as a psychiatric nurse. 

“You’ll cause more harm to these kids by taking them away from someone who loves their kids and just needs the help that they need,” Foster said.

---

This article was originally published by Mississippi Today and is republished here under a Creative Commons license.

Source: Original Article