Survivor – Harm Reduction Advocate – Student Doula
Trigger Warning: opiate use disorder. This post contains a very real, very personal story about medication assisted treatment during pregnancy. Ann believes Real Life Birth Workers is a safe place to share her story. This is a place for connection and support. Please be respectful and empathetic to her journey.
Both of my children were born along my path to recovery from Opiate Use Disorder (OUD), but long before they came, I had been in some sort of healing phase or another. I faced some traumatic events in my childhood. At age sixteen I began to cope in unhealthy ways, including the use of heroin. I was in and out of detoxes, outpatient programs and residential treatment facilities until I pursued my own recovery at eighteen. I did this with the support of a medication called Methadone, which is a form of Medication Assisted Treatment.
I became pregnant two months after. Initially, I was afraid of being pregnant on MAT (not knowing how it could affect my baby) until I met with my clinic doctor. He told me that quitting then would pose a high risk of miscarriage, that untreated OUD can be fatal to both mother and the unborn baby and that I was already prescribed the “gold standard” of treatment. In fact, pregnant women living with OUD have been treated with Methadone since the 1970’s and The American College of Obstetricians and Gynecologists have recognized it as the standard of care since 1998. At nineteen years old, my first year of OUD recovery, my daughter was born on MAT. The birth of my son happened in the part of my recovery which I refer to as long-term recovery, years after ending my life-saving treatment. Both of their births inevitably led to hearing my calling to serve others who have been through similar experiences to me.
The pregnancy, birth and postpartum time of my daughter opened my eyes to how much needed to be done to improve care and decrease bias for people living with or a history of trauma and OUD. In retrospect my birth team and I were wildly misinformed about birthing on MAT. On top of that, stigma was an unwelcome guest in the delivery room. There was a distinct moment during my induction when it became clear. A nurse offered and gave me an IV pain medication called Stadol to ease the discomfort of the increase in Pitocin. I had never heard of it before then, but in that moment anything to help sounded like a great idea. Instantly an overwhelming pain came over me and I began uncontrollably shaking, sweating and crying. The only way I can describe how I felt was like I was ignited and burning alive. When a contraction came over me, it felt like I was drowning. After the first contraction I told the nurse “I’m in more pain!” She responded with, “stop trying to get more pain medication.” I was hurt, confused and my calls for help were blatantly rejected. I began screaming while another suffocating wave of pain came over me. This time the nurses came to put an oxygen mask on my face. I didn’t know at the time, (I’m not sure the hospital staff knew either) but I later discovered that Stadol works against Methadone. It had thrown me into an acute withdrawal phase. I felt like I was unheard and unseen. I wasn’t able to accurately describe the pain because how overwhelming it was. I assume, because of my history of previous drug use, my pain was being overlooked and expected that it wouldn’t be able to be managed. was told to be quiet because they could hear me down the hall and other laboring moms weren’t as loud as me. I knew birth was going to be the hardest thing I had ever done, but I didn’t anticipate this type of suffering. To add insult to injury, I was very surprised to find that when the anesthesiologist finally did come to place my epidural, the numb sensation brought on another unexpected dimension to my experience. An amplified loss of my physical autonomy. A feeling that was all too familiar from my childhood which caused my trauma.
My baby girl was born assisted with a vacuum. There was a mandatory observation period where she had to remain in the hospital. During that time she had to be scored at regular intervals using then what was called the COW scale to determine if she was showing any signs of Neonatal Abstinence Syndrome. They tested her meconium for drugs without my knowledge or consent, and a social worker became briefly involved. She did not require treatment for NAS and the drug tests came back favorably. I tried to accept what happened. I told myself to be thankful that it was me who went through the birth trauma “instead” of my baby going through NAS. But the reality is that no one chooses to have a traumatic birth. Women treated with Methadone or Bupenorphine have infants with lower risk, less severe, and less treatment time of NAS.
The subsequent birth of my son made me realize that birth workers can make a real impact for people who are or have been in my shoes. I knew I wanted a different experience this time. I set the intention to surround myself with a low intervention birth team. 32 weeks into my pregnancy my fiancé, daughter and I moved to Washington after accepting a new job. We explored alternative options in maternity care. I checked out a few books at the library to do some research and fell in love with Spiritual Midwifery by Ina May Gaskin. I figured that midwives in a birth center would align with my goals so I found and established care with a group of midwives right away. On day one, they encouraged me to tour their birth center and pick a room that I wanted to have my baby in. We met in that room every time we had an appointment and had meaningful conversations in spans of time that went far beyond a standard OB visit. During his birth I felt their circle of support as they encouraged me to lead the way and held the space for me to do so. The experience was profound simply by being heard, seen, safe, and supported. A moment I could finally “reclaim” my autonomy once again and begin to heal in a different way. It was then I heard my calling to serve others by becoming a birth worker, too.
I began my Doula & Trauma Informed Professional training in 2019 and I’m coming up on year thirteen in recovery from OUD. I home-school my two kiddos who are now five and eleven. The process of doing this inner-work and becoming certified has not been an easy one for me, but it’s also been a time that I have learned quite a lot from and have come to cherish. I’m actually kind of thankful that I was struggling. I posted about needing help on a Doula group and ended up being connected to a women run support group for Moms on MAT by a fellow Doula. It was there I found my tribe I didn’t know I was looking for. Thankfully my training organization has been so supportive of doing the work in my own way and at my own pace. I think because I’ll be a more informed birth worker by the end of it. I have also been able witness some of the most amazing birth stories of overcoming strength and perseverance from my peers during this time.
Of course I am eager to become certified, but I also intend to always be a student of trauma, addiction and birth. I look forward to serving my clients in meaningful ways along their own unique birth journeys. I know how needed it is to be able to turn to the support of someone who needs no convincing that you are the best person to make decisions for you and your baby, someone who already knows that your potential is limitless.
Do you love birth? Heck yeah you do!
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