August 1, 2021
Mercy Health’s New Beginnings offers help for pregnant women with addiction

Sandy Kiyak’s goal for her patients is simple: to guide each one to the birth of a healthy baby.

It’s no different from the goal of any obstetrical program, but considering that many of the expectant moms in Kiyak’s care live with addiction, it’s bold. Nevertheless, the registered nurse and perinatal care coordinator at Mercy Health Franklin Avenue OB/GYN in Toledo is confident that the right kind of care and support can make a difference.

Kiyak is a driving force behind New Beginnings, a program created to address the special needs of pregnant women with addiction. It isn’t drug treatment or detox; patients are referred elsewhere for those services. Nor is the medical care especially different from that offered to other expectant moms who go to Franklin Avenue.

A pregnant woman who comes to Franklin Avenue, whether in New Beginnings or not, can count on complete wraparound services — prenatal care, delivery at Mercy Health’s St. Vincent Medical Center, postpartum care and breastfeeding help. If she needs behavioral health care or addiction medicine, including medication-assisted treatment, those are available, too.

The difference for New Beginnings moms is extra support, from peers and professionals. Women in the program meet at the clinic once a week for group sessions run by a licensed social worker. Coming together to share their stories and experiences lends invaluable moral support for the incredibly difficult task of overcoming addiction amid the stresses of pregnancy, poverty and other challenges. A focus on lifestyle changes is meant to prevent relapse among women who have achieved sobriety.

While they’re on-site, they have their routine prenatal doctor visits if they’re due for one and attend classes on parenting, breastfeeding and other topics. The co-located services make it easier for women with transportation barriers to keep their appointments.

New Beginnings launched in January. It’s an outgrowth of the Healthy State Alliance — a partnership between The Ohio State University Wexner Medical Center and Cincinnati-based Mercy Health. The idea of the Healthy State Alliance, formed in 2018, is to combine the vast resources of Ohio State’s major academic medical center with the broad geographic reach of Mercy to tackle some of Ohio’s most critical health problems.

It’s not surprising that the state’s persistent opioid crisis has been a focus from the start. Nationwide, the numbers for pregnant women are grim. According to the Centers for Disease Control and Prevention, the prevalence of opioid use disorder among women giving birth in hospitals quadrupled between 1999 and 2014, from 1.5 per 1,000 to 6.5 per 1,000.

The toll also can be measured in the misery of newborns suffering from neonatal abstinence syndrome (NAS), which afflicts its tiny victims with tremors, convulsions, fever, and problems eating and breathing. The Healthcare Cost and Utilization Project said in 2016 that, for every 1,000 newborn hospital stays, seven babies were born with NAS. That’s nearly 80 newborns every day, or one every 19 minutes.

New Beginnings is modeled on Wexner Medical Center’s Substance Abuse, Treatment, Education and Prevention Program (STEPP), which typically enrolls up to 60 women at a time. New Beginnings started with a “soft launch” amid COVID restrictions and expects to see the program grow with time.

Kiyak wants to build it carefully. She sees the need for a dual education effort — first, convincing pregnant women with addiction that they won’t be judged. “The stigma around this has to change,” she said. “We have to make them see that we’re here to help.”

And as for other health care providers, some of whom are in fact inclined to judge, Kiyak has a message: “Our patients that we take care of — this is somebody’s daughter. Somebody’s sister, granddaughter, friend and aunt. We want to help them. It’s really as simple as that. We are not here to judge. We are here to help.”

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