Moms-to-be get on a better path

An innovative Kaimuki medical clinic helps pregnant women get off drugs and teaches them crucial parenting skills

Twenty-one year-old Amanda Tapec is almost eight months pregnant and six months clean from her crystal methamphetamine addiction. Well on her way to carrying her baby to full term, she also has quit smoking and started attending classes in prenatal care and child rearing. When she discovered she was pregnant, she initiated the difficult changes, but she credits the PATH Clinic in Kaimuki with getting her to this point.

"I don't think I would have done it if I hadn't had a lot of support here," said Tapec, relaxing on a couch in the living area of the clinic, which feels more like a modest home. "The way they talk to you is so caring and loving. It's like you're already their family."

PATH stands for Perinatal Addiction Treatment of Hawaii, and it opened last April. Founded by obstetrician/gynecologist Tricia Wright and staffed with nurses and a social worker, it provides transportation to the clinic, where former or current drug addicts can receive proper care before and after the baby's birth, counseling for addiction issues, support, friendship, education about pregnancy and childbirth, and a respite from parenting a newborn (child care allows new moms to attend classes and counseling sessions without interruption).

The clinic -- struggling for approved yet unreleased government money -- recently received a $5,000 grant from the Women's Fund of Hawaii.

"We're reaching a hard-to-reach audience," said nurse manager Renee Schuetter, who explained that pregnant women using drugs are afraid of judgment, jail and losing their children. If they feel threatened, they won't come in for treatment, which means an increased risk for dangerous pre-term deliveries, and less hope that the woman will kick the drug habit and be able to parent. "We're all about breaking down those barriers."

In fact, the back of each staff member's business card reads, "Confidential medical care in a warm homelike setting. No judgment. ... A lot of support." The 300 nursing students, medical students, residents and fellows who have completed part of their training at the clinic supplement this unique approach.

Statistics indicate that the nonconfrontational technique works. In 13 months they've treated 80 women. Of 21 deliveries, 20 reached full term. The only mother whose addiction caused an early delivery had joined the clinic just two weeks prior. But the staff continued to work with her, and she's now drug free.

"For us to have 20 babies full term is like a blessing from heaven," said Schuetter. "If we prevent one very low-birthweight baby, it saves over $200,000 in medical expenses." Pregnant women get free cab rides to the clinic to ensure they make appointments. Riding the bus earns rewards, but for those who are very pregnant or struggling with newborns, transportation is everything. "A cab ride from Wahiawa sounds outrageous," said Schuetter, "but it's nothing compared to the cost of a pre-term birth."

After much struggle, one woman with a 20-year history of methamphetamine use finally allowed the staff to send a taxi to bring her to the clinic. She was pregnant for the ninth time. Child Welfare Services had taken away all eight of her children. But now she's clean, learning to parent, practicing birth control and "doing really well," said Schuetter, who added that PATH serves "as a bridge between the old culture and new culture" -- and, in the process, helps new mothers meet their responsibilities with plenty of practical help and emotional support.