Perinatal Recovery Support

Pregnancy is a daunting and vulnerable experience. For women with opiate use disorder, the stressors of pregnancy are often compounded by self-doubt, stigma, and judgment from family members, friends, and authority figures. These feelings can deter women from seeking recovery support or prenatal care, and the public health ramifications are clear: from 2017-2018, accidental overdoses contributed to 39% of pregnancy-associated deaths in Philadelphia.

I currently serve as a Family and Child Advocate at Stephen Klein Wellness Center, a federally qualified health center operating under Project HOME, a nonprofit founded to meet the needs of Philadelphia’s homeless community. I am responsible for providing case management and resources for pregnant patients with opiate use disorders. This can look like anything from signing patients up for food assistance, coordinating with local doula programs, advocating on patients’ behalf to their parole officers, addressing transportation barriers, and enrolling patients in our clinic’s medication-assisted treatment (MAT) program to help them reach their recovery goals. Many of the patients I work with are street homeless or otherwise experiencing housing insecurity, and lack safe places to store medication and means to coordinate appointment times with clinic staff.

For individuals who are also in active withdrawal from opiates, the process of beginning prenatal care or simply sitting through a long wait time for a medical visit can be stressful, overwhelming, and triggering - especially if they have previously experienced trauma in healthcare settings. The OB Walk-in Clinic at Stephen Klein Wellness Center is designed to mitigate some of these challenges. Each Wednesday afternoon is blocked off to provide flexible, low-barrier care to prenatal and postpartum patients experiencing homelessness and substance use disorder. During their appointments, I provide patients with gift card incentives and bus passes, which they are eligible for through a grant from the Pennsylvania Department of Drug and Alcohol Programs. Patients are also connected with behavioral health services, hospitality, and legal support.

Broadly, SKWC’s OB walk-in clinic has helped maintain high rates of patient retention and increased access to prenatal and postpartum care. But on a more interpersonal level, I’ve found that taking time to build relationships goes a long way in itself. The patients I work with have experienced lifetimes of trauma, and it is incredibly humbling to help provide a safe space for them. There is much to be done to tackle disparate rates of maternal and infant mortality in Philadelphia, but encouraging compassion and reducing stigma within the healthcare setting is an important first step.