Area health officials, after watching an alarming increase in the number of women who use drugs and the effect it has on their babies, say that a coordinated approach is critical in encouraging pregnant abusers or women with young children to end drug use.
Maryland officials announced this week they will open a $2.5 million center in Baltimore that will provide a broad range of programs, including specialized obstetrical care, help with educational and career planning, psychiatric counseling, a 16-bed residential treatment program and outpatient drug treatment for such women, their babies and families.
The program will be open to all Maryland women regardless of ability to pay. The Center for Addiction and Pregnancy, to be housed at the Francis Scott Key Medical Center, is expected to open early next year.
"Pregnant addicted women throughout the programs in the state are treated as any other person coming in for care," said Adele Wilzack, secretary of the Maryland Department of Health and Mental Hygiene. "We lose lots of the women in the system" who get frustrated with being referred from agency to agency and drop out, she said.
In the District, health officials, criticized last spring by a 23-member committee of law enforcement and judicial officials for not paying enough attention to drug treatment, are developing a 25-bed program for pregnant addicts, the first inpatient program specifically designed for those patients.
In Virginia, health officials have applied for a five-year federal grant to coordinate and offer at the local level drug treatment, social services, family planning and other programs for women.
The demand for such services is increasing at an alarming rate.
In Maryland, more than 7,400 babies were born last year who had been exposed by their mothers to crack cocaine, other illegal drugs or alcohol. In the District, 2,000 babies are born annually to mothers who abused drugs while pregnant. And in Virginia, health officials estimate that more than 8 percent of pregnant women abuse drugs or alcohol.
A three-year pilot program in Baltimore that offered obstetrical care, drug treatment and other counseling services in the same location seemed successful. The program also provided child care and other help, and more women stayed off drugs during their pregnancies. The time their newborn babies had to remain in neonatal intensive care decreased from an average of 21 days to 24 hours.
"If provided the comprehensive service while the lady is there, the outcome is better: a healthier baby, a nonaddicted baby," said Todd Rosendale, a coordinator with Maryland's Alcohol and Drug Abuse Administration.
But even with coordinated services, other drug treatment specialists who work with pregnant users say they aren't always successful. Services at the Center for Prenatal Addiction at the Medical College of Virginia include a wide range of services, but in two years only 18 of the hundreds of women enrolled in the program remained there. Seventeen of them delivered drug-free babies.
"We have a very hard time getting women to stay in treatment," said Catherine A. Wilson, a nurse coordinator of the Richmond-based center, where a quarter of the babies born in the area are drug-affected. "We aren't sure why."