Maternity centres around the world are set up to encourage healthy bonding between a mother and her newborn. Babies room in with their mothers to encourage skin-to-skin contact and breastfeeding. Research has shown this rooming-in approach strengthens the mother-infant bond and helps babies thrive.
However, for newborns of mothers struggling with addiction, the story is quite different. In anticipation of withdrawal symptoms, these babies are removed from their mothers and put in a quiet room with no stimulation. As a result, there is no bonding and no breastfeeding. Predictably, many of these infants end up in foster care, and their mothers – now childless – return to substance use.
Since 2002, a program at BC Women’s Hospital & Health Centre led by Dr. Ron Abrahams has challenged this approach. The Fir Square Maternity Unit helps substance-using mothers and their newborns to stabilize and withdraw from substance use, and is the only such unit in the world that provides rooming in for these mothers and babies.
“Our attitude is that these women are capable of rooming in and being safe with their babies if they’re supported,” says Abrahams. “We believe that babies are better off in the care of their mothers than being separated from them.”
While this idea may seem radical, it’s grounded in solid research evidence. A recent study led by Dr. Zoë Hodgson at the Women’s Health Research Institute compared outcomes for more than 1,200 substance-exposed newborns in British Columbia: 371 infants roomed-in with their mothers at Fir Square, while the remaining 834 received standard care at other BC hospitals. Babies who roomed-in were more likely to be breastfed, less likely to end up in the neonatal intensive care unit, and more likely to be discharged home with their mothers rather than into foster care.
Marci Mobbs experienced this firsthand. She and her spouse Randy were long-term drug users in Squamish. When their son was born in 2005, it seemed inevitable that he would be taken from her.
Instead, Marci and baby Tyson were accepted into Fir Square. During their 30 days in the unit Marci learned to care for Tyson while she was supported to begin her recovery. It was the positive push she and Randy desperately needed to get clean. Both parents went on to successfully complete rehab programs, find employment, and start their lives anew. “It’s like three people were born on the day Tyson was born,” says Marci.
“These women do well with their babies if they can be supported in their community,” says Abrahams. “Their struggles are not with their babies, it’s with poverty and substandard housing. That’s where the infrastructure is really lacking.”
The impact of this important research is being felt across Canada, prompting maternity centres to review their practices.
“The word’s getting out now,” says Abrahams. “We’re producing the evidence, and we’re starting to be recognized as a program to be emulated.”
BC Children's Hospital Foundation
Dr. Ron Abrahams is medical director of perinatal addictions at BC Women’s Hospital & Health Centre.
Dr. Zoë Hodgson is director of research at the Women’s Health Research Institute.