The single largest cause of death for Missouri women during pregnancy and in the year after is mental health and substance use disorders. According to the Missouri Department of Health and Senior Services, around 34% of maternal deaths are related to mental health conditions. The rate is similar for maternal deaths due to substance abuse disorders. DHSS found that most deaths were preventable.
Springfieldian Kelly Bilyeu was addicted to drugs during both of her pregnancies. She's sober now and works with women with substance abuse disorder at Preferred Family Health, part of Centerstone in Springfield. She's a peer counselor helping moms and mothers to be who are struggling with addiction. Peer counselors, she said, are those with lived experience who receive certification to be able to help others facing similar life challenges.
"When my youngest son was born, he was taken into state's care, and at that time I was told about the grants and became a client," she said. "I realized how life changing this program was for me and my family and just knew that, like, my story matters and that I would be able to help people and other moms like me. I feel like a lot of times there's a lot of advocacy for children, but there's not really a lot of support for moms."
At Preferred Family Health, two federal grants allow pregnant women and moms with substance use disorder to be paired with peer supports like Bilyeu. The Regional Partnerships Grant helps the organization provide safety, well-being and permanency for children living in homes impacted by substance use disorder. The Pregnant and Postpartum Women's Services Grant provides supportive services to women during pregnancy and after who have struggled with substance abuse issues.
Kelly Bilyeu said she's passionate about being a voice for and supporting moms dealing with substance abuse. She remembers when she first met the person who helped her through the birth of her son while she was facing addiction.
"She looked very professional and she, like, laughed easily and smiled easily. And then she told me that she was an addict, and I it was just blown away. Like, that's not what addicts look like. That's not how addicts behave," she said. "And so, my peer was somebody that — you know, she was just really important to helping me feel seen, heard and valued throughout the entire process."
Bilyeu said recovery looks different for everyone. She needed residential treatment and medical assisted treatment, and the 12-step program she chose was important to her ongoing sobriety. She wants people to know that substance use disorder is just that, a disorder.
"One thing about substance use is it is a coping skill, and it's an effective one. It's not a healthy one, but it's an effective one," she said. "And so, whenever there's trauma, especially early on before the brain can really process it, you know, it's just how do I feel better? And for a lot of people, the answer is to use drugs. And so, trauma really is a gateway to substance use and to addiction. And so, if we're going to treat the substance use and the addiction, then we really have to look at that trauma piece because we have to help families and Individuals learn how to have that trauma exist but to deal with it and cope with it in healthier ways."
Krista Rosenbaum, a certified substance abuse counselor with Preferred Family Health, said they work with a lot of pregnant women and families who are unsheltered, though not all are. Some don't even know they are going to have a baby until late in the pregnancy, she said. They make sure the women they work with are focusing on their mental and physical health, both during and after pregnancy.
"We go on walks with moms, helping them get outside, not isolate, those are good things," she said. "Taking care of their physical health, helping them get to those postpartum appointments, those six week follow up appointments, those are not really attended very well. So that's something that we really try to do. Making sure that they're taking their medications appropriately, taking vitamins, eating appropriately, drinking enough water, all of those things."
She said, they make sure their clients have a community of people who are there to support them. That can include connecting with people who are in recovery, finding a church or enrolling in community classes. And they educate family members like parents and partners so they're better able to support the mom.
Even though Rosenbaum works with women facing addiction, she said any woman who has just had a baby should prioritize mental health. She said new moms who might be experiencing postpartum depression should not be afraid to reach out for help.
"There's so many hundreds of thousands of women that struggle with it after birth, and there's nothing wrong with them. Our hormones are going crazy," she said. "There's so many community resources that are there to help moms like that. OBs are really educated now about helping them, you know, connect in with community partners."