Lebanon
And Mila Smith conspicuously slept through most of the hour-long gathering.
Yet by their very presence, the two added notes of hope and potential to a discussion of a three-year-old Dartmouth-Hitchcock program that addresses part of an intractable problem — the 100,000 New Hampshire residents with some form of substance use disorder — that caregivers and policymakers confront every day.
“This is something that’s working and we need to support it,” said Sen. Jeanne Shaheen, a Democrat and former New Hampshire governor.
Shaheen was referring to D-H’s Perinatal Addiction Treatment Program, a multi-week outpatient program for expectant and new mothers that takes a comprehensive and multifaceted approach to preparing them for parenthood and treating their substance use disorders.
“Treatment makes a huge difference,” said Daisy Goodman, a nurse midwife and coordinator in the program.
So far, 86 mothers have completed the program, and it currently has 31 active participants, Goodman said. The program aims to reduce unhealthy and costly premature births, stop the spread of infectious diseases like Hepatitis C and prevent neonatal abstinence syndrome — withdrawal symptoms in the newborns of drug dependent mothers.
On Tuesday, Mila Smith didn’t testify to the program’s effectiveness. She couldn’t even understand the words being spoken. After all, she is only two weeks old.
But Mila, with her head on her mother’s chest, spoke volumes about the program’s potential benefits. Mila’s mother, Ashley Raymond, of Enfield, credited the program with helping her prepare for parenthood and break the grip of a disorder tied to the drug use that she began as a 14-year-old student at Mascoma Regional High School.
Asked about which parts of the program were effective, Raymond said, “Everything works.”
Substantial legal and cultural barriers shield the public from awareness of the pain and challenges that face young families affected by the opioid epidemic and other substance use disorders.
But there are statistics. About 7.5 percent of the pregnant women admitted to Mary Hitchcock suffer with opioid use disorder. The number of babies born with neonatal abstinence syndrome in New Hampshire hospitals had already reached 150 in 2011, and almost certainly has continued to climb since.
But the human toll can’t be expressed in numbers. Consider the guilt experienced by Jessica Aldrich, the mother of six-month-old Asher. “My addiction … was not his fault,” she said.
Aldrich said the program helped her care for Asher as he endured the syndrome — it was worst on the fourth day, she said — and helped her get past her initial surge of guilt.
“He deserves better,” said Aldrich as Asher played with a toy butterfly and looked curiously at the adults clustered in the small room. “That’s been my motivation from the start.”
Aldrich said that pregnancy spurred her to seek help ending the drug use that she had begun as a teenager and she enrolled in the D-H program. Aldrich now travels each week to D-H from her Claremont home to participate in a group where she gets support and offers encouragement to a new cohort of mothers.
“Your willingness to tell your story is important, because it provides hope to other people that they can succeed,” Shaheen said.
The program, which derives most of its revenue from Medicaid, a state-federal health insurance for low-income people, faces its own challenges.
“We are not moneymakers for the hospital,” Goodman acknowledged.
D-H Chief Executive James Weinstein, who attended the event, didn’t seem anxious to discuss how the hospital has cobbled together the resources to support and showcase a program that, by all accounts available Tuesday, has served well its participants and their communities. “It’s not only about money,” he told a questioner.
Shaheen cited support for the program as “one of the benefits of the expansion of Medicaid in New Hampshire.”
Weinstein said that part of the work of building a financial foundation for the program could be included in a broader move to redirect resources to efforts that improve the health of patients and communities: “We have to go beyond insurance to restructure the delivery system.”
In the end, Tuesday’s message was in an optimistic key. Said Shaheen: “Hopefully, it’s a model we can share.”
Rick Jurgens can be reached at rjurgens@vnews.com or 603-727-3229.