For pregnant and postpartum people navigating substance use disorder, the months after childbirth are a critical window for care. In Pennsylvania, where overdose rates remain high, that support is especially urgent.
“In our program, we see that our highest rates for relapse happen between six and eight months post-partum,” said Maria Kolcharno, director of addiction services at The Wright Center for Community Health. “Our premise is that mothers tend to experience stressors in their new role, compounded by behavioral health issues that have surfaced in their early recovery.”
To better understand what health workers should know about maternal substance use—and what’s often missed—PGN reached out to Kolcharno, who brings more than four decades of personal recovery to her work and leads the Healthy Maternal Opiate Medical Support Program, or Healthy MOMS.
She shared what she’s seeing among pregnant and postpartum women, how stigma shapes care, and how staff can use a tool that is often overlooked: lived experience.
Here’s what she had to say.
[Editor’s note: This interview was conducted over email and edited for length and clarity.]
PGN: Can you describe the Healthy MOMS program?
Maria Kolcharno: The program supports pregnant and postpartum women with substance use disorder through case management, medication-assisted treatment, and coordinated care across nine counties in Northeast Pennsylvania.
Our mission is to stabilize this high-risk demographic and facilitate access to the necessary support for managing chronic conditions in conjunction with the complexities of pregnancy and postpartum experiences.
PGN: What trends are you seeing around substance use among pregnant or postpartum women?
M.K.: In Northeast Pennsylvania and throughout the state, the trends related to maternal substance use disorder present a complex landscape characterized by evolving drug supplies, enhanced screening protocols, and ongoing regional challenges. Despite a recent decline in the incidence rate of Neonatal Abstinence Syndrome, Pennsylvania has consistently ranked among the highest states for opioid overdoses. In 2020, the Northeast region reported an NAS incidence rate of 14 per 1,000 live births, surpassing the statewide average at that time.
While opioids continue to pose a significant concern, there is an observable increase in substance use that extends beyond opioids to include cannabis and stimulants.
Data suggest that substance use during pregnancy is frequently more prevalent among women experiencing depression, those residing in high-poverty areas, and those enrolled in Medicaid insurance programs.
In the Healthy MOMS Program, we see that our highest rates for relapse back to using happen between six and eight months post-partum. Our premise is that mothers tend to experience stressors in their new role, compounded by behavioral health issues that have surfaced in their early recovery.
PGN: What are some challenges or obstacles that make caring for moms with substance use issues distinct? What do you wish more health workers understood about what these moms go through as they navigate substance use and recovery?
M.K.: Pregnant women grappling with substance use disorders face a multitude of significant barriers that hinder their access to effective treatment. These challenges are often compounded by societal stigma, which perpetuates negative perceptions and discourages open discussions about their struggles. Many women experience a paralyzing fear of disclosing their substance use, concerned that doing so might lead to losing custody of their children.
Additionally, disparities based on gender and race can exacerbate these issues, making it even more difficult for certain groups to find the support and care they need. Mental health complications often accompany substance use, creating an intricate web of problems that further complicate their situations. Public policies may not adequately support these mothers, leaving gaps in available resources and services.
The journey toward treatment can be daunting, as it is often time-consuming and fraught with obstacles.
These mothers battle not only the physical and psychological aspects of their addiction but also the pervasive guilt that comes from societal expectations of what it means to be a good mother.
PGN: How does lived experience shape your approach to this work?
M.K.: One aspect that is unique to our program is that many of our Healthy MOMS staff and I are in recovery for substance use disorder. Recovery is a fundamental aspect of my life. I proudly maintain 40 years of sobriety and actively participate in 12-step recovery programs. This personal commitment profoundly influences both my daily actions and my professional practice.
I provide support to mothers who are experiencing deep despair, offering hope, resources, and programs that empower them to reclaim control of their lives. It is vital to affirm that this stage in their lives holds immense potential and to help them recognize that they are not alone on their journey.
In honor of the support I have received, I strive to be a guiding voice, creating a space for healing that is free from the stigma associated with addiction. My goal is to demonstrate that recovery is attainable and that every individual deserves the opportunity to lead a healthy life, which can often be difficult for a pregnant mother to envision.
PGN: Looking back at your work with these women, what approaches seem to work best?
M.K.: One of the most significant insights we gained is how beneficial it can be to simplify communication between partners and health care providers. By implementing a common joint release form, we hope to relieve mothers of the emotional labor of retelling their stories. We know how taxing that can be, and our monthly clinical meetings with partner organizations are designed to ensure that everyone involved in a mother’s care is on the same page, providing a united support system.
Our “team meetings” foster an inclusive environment where representatives from partner organizations and mothers come together. This collaborative approach encourages open discussions and enables mothers to express their challenges, empowering them to actively work with the team to find effective solutions.
We recognize that many mothers face significant barriers, including stigma, transportation issues, and childcare concerns. That’s why we try to meet them where they’re at, offering stacked appointments so they can receive care on the same day. This small adjustment can make a remarkable difference, reducing the hurdles that often lead to missed sessions.
This article was supported by Life Unites Us, a health campaign that receives funding from the Pennsylvania Department of Drug and Alcohol Programs. Public Good News retains full editorial control over its reporting.