The Silent Anguish of Pregnant Women Who Struggle With Addiction

In early July, Mallory Loyola, 26, was charged with assault after her newborn girl tested positive for meth. Loyola is the first woman in the state to be arrested under a new Tennessee law that “allows the state to criminally charge mothers for the illegal use of a narcotic drug while pregnant,” if their children are harmed or addicted to the drug.

Many medical experts and reproductive rights advocates warn that this kind of legislation is detrimental to women and worry that similar legislation will be passed in other states.

“When we create this climate of fear, we’re endangering these families,” says Micaela Cadena, policy director of Young Women United, a community organizing project by and for young women of color in New Mexico. The organization works with many pregnant women who struggle with addiction in a state with a disproportionate amount of drug use.

This year, Young Women United organized a series of working groups with women who had been using substances while pregnant, and collected and assessed their experiences with attempts to seek prenatal care. According to their report, “Everyday Struggles Everyday Strengths,” most participants have described intense feelings of fear, which guided their pregnancy-related decisions. The overwhelming majority felt they were judged when trying to access prenatal care. Many shared that they were treated without kindness or basic respect, and that their providers let their personal opinions on addiction impact their care.

“The nurses treated me mean because a lot of blood work is done while being pregnant. I had no usable veins so someone from inpatient had to be called to hit my artery. I went through a lot of pain and judgement. A nurse told me ‘Once a junkie always a junkie,’ ” one anonymous participant shared.

“They should have support from their families and doctors; some doctors are kind of mean. They blame the mom, say it’s their fault, say the baby will be messed up, but they are not doing anything to help. Instead of trying to put them down, they should be working to get women help,” says Myra Salazar, a program participant, in an email to Truthout. Salazar is 55 and a parent of five children in Albuquerque, New Mexico. Her struggle with addiction began in 1989.

Salazar feels that she and other women like her are unfairly judged. “Addiction can be from a lot of things – like for some, it’s trauma. From the outside people think someone’s doing drugs just to do it. But maybe someone is putting them down; they are on the street. No one knows what it’s like. It’s hard, really hard, to stop using,” Salazar says. “If you’ve never been there, try to understand where someone is coming from, and see how hard they are working to get through every day.”

According to Denicia Cadena, communications and cultural strategy director at Young Women United, only one woman the organization has worked with described having a good relationship with her physician. She says this population is too often misunderstood. She points out that many people of color in New Mexico have experienced generational trauma, particularly in native communities, and drugs become their coping mechanism. “These are not irresponsible women who don’t care about their lives,” she says.

Monica Simpson, executive director of Sister Song Women of Color Reproductive Justice Collective, says a lot of facilities and programs don’t take into account motherhood or pregnancy. “People don’t understand their story. There’s automatic judgment. They put them in the ‘bad mother’ category,” she says. “This is not promoting family values. This is making folks live in fear. You can’t grow a family in fear.” Simpson says there is a desperate need for holistic programs that are specifically tailored to pregnant women, and that incorporate parenting, counseling and nutrition.

Young Women United used the information they gathered from their participants and created the New Mexico House Memorial 14 Task Force Legislative Report, which they submitted to the state’s Health and Human Services Committee. The report found that a significant barrier to improving services for pregnant women with substance abuse issues is the lack of a complete inventory of appropriate programs and professionals who are currently providing this care in New Mexico. Micaela Cadena says these women should consistently receive prenatal care and treatment from the same providers throughout their pregnancy so their full needs are being met.

The women at Young Women United praise the El Milagro Program at the University of New Mexico Hospital, the first program in the state for pregnant women with substance abuse/addiction issues. El Milagro has served over 2,000 women since 1989. Unfortunately, however, budget cuts required them to cut their inpatient services in 2011.

“The Milagro program worked; they helped me out a lot. I was living in their housing and going to the groups and outings they had for us,” says Salazar. “We all had to learn and practice cooking. Milagro helped me get food stamps and housing. That kept me from using.”

Denicia Cadena points out that there aren’t laws in New Mexico that criminalize drug-addicted mothers, but in practice it’s another story entirely. She says medical professionals have an incorrect understanding of neglect and abuse laws and fear that they will be held liable if there is a problem with the pregnancy. As a result, many mothers are reported to the authorities and separated from their children. “When we criminalize pregnancy, we push people towards the shadows,” she says.

Shannon Casteel, 30, is familiar with the fear that comes with addiction during pregnancy, which is why she’s opposed to the new legislation in Tennessee. “This is doing nothing but pushing addicts into hiding. Is it supposed to scare addicts? You think jail is going to scare them?” she says.

Casteel struggled with addiction for many years. She grew up in Nashville with a mother who was addicted to heroin and provided her with marijuana, pills and alcohol when she was a child. She remembers that at the age of 12, her mother gave her Valium the first time she cried over a boy. “I latched on immediately to the release I felt,” she says.

As Casteel grew older, she began engaging in unprotected risky sex and associating with dangerous people. She dropped out of school at the age of 14. “It still blows my mind what was normal to me,” she says.

When Casteel was 18, her mother was diagnosed with cancer. While she was sick, Casteel began abusing her pain medication. She was completely distraught when her mother died shortly after. “It was like I was living to die, like I had a suicide mission,” she says.

Casteel was in and out of jail for a few years after that. “I had no idea how to live without drugs or alcohol,” she says. At one point she attempted suicide after she was put under house arrest and released to her grandmother and step-grandfather, a man who had raped her 15 years prior.

Eventually, Casteel says, she was allowed to live in a halfway house. “I could hardly read or speak. It’s like I had been living with animals. I didn’t know how to live in society.” During that time Casteel began dating a man and became pregnant. She was 22. Because her relationship and pregnancy violated the rules at the halfway house, she was sent back to jail.

Casteel battled her addiction to multiple drugs during the next several years. During her first pregnancy she lived at Renewal House, which is considered one of the top residential addiction treatment programs in the state. It allows residents to live with their children while in treatment. Though Casteel successfully completed the program, she continued to battle her substance abuse. “It’s hard to restore someone when there isn’t anything to restore them to.”

There was a time during which Casteel’s addiction was so severe she was unable to get out of bed and make her baby a bottle without the help of opiates. During her second pregnancy, she attempted to detoxicate herself on her own, which is extremely dangerous to both the fetus and mother. “I hated myself. It was out of my control, and I didn’t know what to do.”

Casteel feels that one of the obstacles these women run into when seeking treatment is the rejection of pregnant women at rehabilitation programs. Casteel knows firsthand since she’s been on both sides of the situation – as a pregnant woman seeking help and an employee at a rehab center. “It’s an automatic no,” she says. “They’re not going to touch you with a 10-foot pole. Doctors are afraid of getting sued.”

Casteel has been in recovery for 10 years now and drug-free for three consecutive years. She has been in treatment facilities, counseling and group therapy, “What helped me the most was the terrible pain caused by the hopelessness of this disease, because without it, I may have never sought out a spiritual solution to my malady.”

Now Casteel dreams of creating a treatment facility specifically for women who are pregnant, called Mother’s Mosaic. She says it would be place where women receive the holistic care they need while still living with their children.

“The misconception is that there’s a choice in the matter,” Casteel says. “We need more access to health care. These people [lawmakers] are looking for a quick fix, a short-term solution. Women are so afraid of losing their children that they hide.”