BY HELEN ALTONN AND TINA SHELTON FOR UH – A University of Hawai’i John A. Burns School of Medicine program for high risk pregnant women has far surpassed expectations—delivering healthy babies and saving high costs of premature, low weight infants.
Perinatal Addiction Treatment of Hawai’i – known as PATH—“is not really a drug treatment program,” said State Rep. Marilyn Lee. “It’s a place women come and they get pretty comprehensive services…They learn being a good mother is a good thing and, in the process, they’re able many times to get off drugs and deliver a healthy baby.”
The Women’s Legislative Caucus supported PATH’s beginning as a pilot project in a small house in Kaimuki in April 2007 and has dedicated its 2011 legislative package to Dr. Tricia Wright, the founder. “It has been so successful and had such good outcomes, we wanted to honor her in some way,” Lee said.
Wright also was honored with an invitation in November to appear as a perinatal expert on the Dr.Phil television show, which aired Feb.2. “It was amazing, surreal almost,” she said.
The legislative package includes a bill, HB 129, to appropriate money for continued operation of the clinic, which has served 180 prenatal and postpartum women and had 120 births. “
“It’s saving money in the long run,” Lee said. “High risk mothers who deliver high risk babies are a huge cost factor in the state.”
The cost to care for one premature infant for one year—an average of $200,000—would pay for the cost of the clinic for a year, said Wright, assistant professor of obstetrics and gynecology and PATH medical director.
“Ideally, I would like a fully staffed medical home for these women and children with a family practice doctor or pediatrician,” she said. But the program is struggling financially and with funding cuts, she said, “I’m afraid we re going to lose some staff because of their worries about wanting more stability.”
Wright said she was “completely astonished” by the Women’s Legislative Caucus recognition. “It is quite an amazing award. Just looking at women who have won it before, I didn’t feel like I was the same caliber.”
Women receiving PATH’s services feel differently: Shaunte Rivera, 27, of Kapolei, said she doesn’t know what would have happened to her without the clinic’s help. After losing custody of four children because of a crystal methamphetamine addiction, she delivered her fifth baby “clean and sober” at the PATH Clinic.
Renee Schuetter, Executive Director of the PATH Clinic, said it receives more referrals each year of women who are at extremely high risk for unhealthy births. These women have four to five times greater than average risk for premature births and a low birth weight child because of such factors as substance abuse, high rates of smoking, poverty, homelessness, medical or psychiatric illness.
However, birth outcomes “are amazingly average,” Schuetter said. “That is a huge success.”
The clinic expects to have 60 births this year, with seven already in January, she said… “We’re seeing 23 pregnant women now… There are times when we think, ‘Oh oh, are we over our heads?’ But things work themselves out.”
Schuetter said the program does “an incredible amount with very little money,” providing comprehensive prenatal, delivery and postpartum care and social services, transportation assistance to and from the clinic for appointments and classes, and motivational incentives, such as yoga and acupuncture.
Although it isn’t a drug treatment program, 80 percent of women who receive PATH Clinic services abstain from illegal substances during their pregnancy, which allows them “to prepare themselves to parent their new babies,” Schuetter said.
The clinic also has a smoking cessation program funded by the Hawai’i Tobacco Trust Fund that is available to all women of childbearing age on O’ahu. The comprehensive program reduces the number of pregnant women who smoke during pregnancy and helps them develop coping skills to remain non-smokers during the stressful months after the baby is born, Schuetter said.
The clinic provides a great deal of breastfeeding support to women because it helps to prevent tobacco and other substance use relapse, she said. The clinic improved its parenting program last year by adding a family advocate, funded by the Keith and Judy Swayne Foundation, to work individually with women and their partners to be ready to care for their babies, she said. The Atherton Foundation is funding the part-time position this year.
Drs. Gwendolyn (Wendy) Jones and Alexis Apalsca, pediatric residents, received an American Academy of Pediatrics award for their “Baby Steps” program, a series of interactive group classes to increase understanding of infant development and enhance parenting skills. (However, they’re not able to see patients without faculty supervision).
PATH is administered through UCERA (University Clinical, Education and Research Associates), a nonprofit faculty practice organization that supports the medical school’s clinical, academic and research functions. Up to now, the John A. Burns School of Medicine (as part of its community outreach using Tobacco Settlement Special Funds) has provided all medical services at PATH; other costs are covered with small grants from a variety of community organizations and foundations “and we’re blessed with many incredible volunteers,” Schuetter said.
Former PATH client Rivera, a staunch PATH advocate, explained that she ran away from home at age 12, began hanging around with older people and became addicted to drugs. She was in and out of the juvenile detention home, a foster home, prison and drug treatment programs.
She said a friend told her about the PATH Clinic and Catholic Charities’ Mary Jane Home for pregnant women when she was expecting her fifth child. She decided if she didn’t stay clean she “was going to end up dead,” so she sought their help.
“My life right now is surrounded by education and my family—just good vibes,” said Rivera, who takes care of her infant, now two, and is going to school to become a certified nurses assistant. She earned a general education diploma while at the Mary Jane House.
“I pretty much owe them (PATH and Mary Jane Home) everything,” she said. “Without their services, I don’t know where I’d be.”