FL MORRIS / FMORRIS@STARBULLETIN.COM At the Perinatal Addiction Treatment of Hawaii Clinic, located at Salvation Army Family Treatment Center in Kaimuki, pregnant women with substance abuse problems are provided services and counseling. Client Nancy Nakihei, right, holds her newborn baby, Christian Otis, after her clinical visit with Dr. Tricia Wright. Alex Zarella, a therapeutic child care specialist, watched the baby while Nakihei was with the doctor.

Addicted and pregnant but not alone

A clinic operated by UH's medical school helps isle women give birth to healthy babies

Nancy Nakihei said she was thinking of ending her life until she saw an advertisement on a city bus for a program offering prenatal services, delivery and postpartum assistance to substance-abusing women.

She was four months pregnant, using crystal methamphetamine and fighting with her boyfriend, and did not know where to turn for help, she said, until going to the pilot program operated by the University of Hawaii John A. Burns School of Medicine.

Nakihei has been clean ever since, she said, because she wanted a healthy baby. Her son was born Feb. 16. She still attends classes at the clinic and plans to go back to school when her child is older. Her boyfriend, the father of the child, is helping.

Nakihei recently asked the Legislature to pass House Bill 2881 to make the pilot program permanent to help women like her "become a productive member of society."

"We've been thrilled with our success," said Dr. Tricia Wright, who directs the clinic for the medical school. She is assistant professor in the Department of Obstetrics, Gynecology & Women's Health.

She said 67 women have been to the clinic and that it has had 17 births -- "all healthy moms and healthy babies, full term." All but one woman was clean when she gave birth, and she had been going to the clinic only a few weeks, Wright said.

One of the surprises, said Renee Schuetter, a registered nurse who manages the clinic, is that the pregnant women establish a bond with the staff and want to learn more parenting skills.

The program began last April in a house on the grounds of the Salvation Army Family Treatment Center. Patients are from Women's Way, a residential treatment center for women and children.

The Legislature gave the University of Hawaii $400,000 to establish the Perinatal Addiction Treatment of Hawaii Clinic in fiscal 2007 and $200,000 for operations this fiscal year. The medical school is asking for $300,000 for the next fiscal year and removal of the pilot status.

Schuetter points out that $300,000 is about the average cost of medical expenses for a woman and baby when the baby is born prematurely. "So we know if we are able to prevent one baby from (complications of) being delivered too early, we have paid for the clinic."

The March of Dimes Hawaii Chapter recently awarded $10,000 to the clinic to reward women for attending clinic visits and to provide healthy activities, Wright said.

The Women's Fund of Hawaii also provided $5,000 to support an activities director and therapeutic activities.

Nakihei praised the clinic's array of services, including medical care, drug education classes, parenting workshops, activities such as sewing, hands-on care with children and discussions with health care professionals.

The clinic's supporters say pregnant women who use drugs often will not seek care, fearing prosecution and loss of their children.

Women are welcome to go to the medical school's clinic after giving birth to learn model parenting behavior, nutrition and healthy habits, Wright said.

"Weight gain can be a trigger for relapse," she said. "When they relapse, we're here to talk to them about it. ... It's just an opportunity to provide more education and sometimes get them into residential treatment."

Schuetter said some women go to the clinic two or three days a week to learn to care for their baby, and it is not always their first child. Once it was for the ninth child of a woman who had lost her children to child welfare services because she was on drugs when they were born, she said.

"Even if it's the ninth child, it's really the first child the mother is parenting, and they've been very accepting of our nurturing and support and education," Schuetter said.

She said another woman who lost several children to child welfare is doing a good job of parenting her baby and is starting a program to become a medical assistant.

The woman had been drug-free since the seventh month of pregnancy and quit smoking after the baby was born because she was nursing for the first time and did not want nicotine in the milk, Schuetter said.

She said this was "a total surprise to us. We were focused on much more difficult and seemingly more dangerous drugs."