ROCHESTER, N.H. — The young women, soon to be mothers, gathered around a big kitchen table, chatting excitedly about due dates and baby names and even morning sickness.
But these were not typical expectant mothers. They had used opioids, mostly heroin and fentanyl. Many had been incarcerated. Few had families they could turn to for help, and the fathers of their babies were out of the picture.
Most of these women — tough, sassy, vulnerable — were destined to go through their pregnancies in a shelter, jail or even on the street, fending for themselves as they had often done before.
Instead, here they were last week, in the cozy kitchen of a classic 1856 New England farmhouse where the aroma of fresh-baked cornbread filled the air. Set before them was a comfort lunch of tomato soup and grilled cheese sandwiches.
It was opening day at Hope on Haven Hill, a private house that its owner, Dr. Colene Arnold, had moved her own family out of so these women could move in.
“This place is crazy pretty,” said an awe-struck Ariel Robbins Perkins, 24, who is 12 weeks pregnant and arrived here straight from jail. (The New York Times conducted a Facebook Live interview with Ariel that day.)
Hope on Haven Hill, financed by $480,000 in federal funds and more than $150,000 in private donations, provides a safe, supportive environment where eight women who are either pregnant or newly postpartum can live while receiving comprehensive treatment and counseling for substance use disorders. Their days will be highly structured, with group therapy, private counseling, childbirth classes, life skills coaching, recovery support services and enrichment programs. Medicaid will reimburse Hope on Haven Hill for the services.
Because opioid users are vulnerable to relapsing after they deliver, the women can stay at Hope on Haven Hill for up to a year after giving birth. If they have other children younger than 5, those children can live here, too. This is part of Haven Hill’s philosophy of keeping mothers and babies together and alleviating the widespread fear among pregnant drug users that if they seek help, their children will be taken away.
New Hampshire has two other small facilities for pregnant women with substance use issues. But as the opioid epidemic has worsened, both have long waiting lists.
The need is growing, as evidenced by the dramatic rise in the number of babies born with neonatal abstinence syndrome, in which the newborn suffers withdrawal from the mother’s drug use.
In 2000, the syndrome was diagnosed in 1.5 babies per 1,000 births in New Hampshire; by 2012, that rate had soared to 15 babies per 1,000 births, said Dr. Bonny L. Whalen, a newborn pediatrician at Children’s Hospital at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.
The rate now, she said, is even higher.
New Hampshire’s rate is almost triple the national average, but it is still a major problem across the country. As of 2012, the federal government says, one baby was born suffering from opioid withdrawal every 25 minutes.
That national rate, too, is higher now. The federal government said last week that opioid deaths had continued to surge in 2015 and for the first time in the nation’s history surpassed the number of deaths from gun homicides.
Emma Lee, a tiny infant born with neonatal abstinence syndrome, was the first baby to arrive at Hope on Haven Hill on opening day last week. She had spent all 32 days of her life in a neonatal intensive care unit because her mother, Amanda, 31, who was homeless for the first six months of her pregnancy, had used heroin for most of that time and then went on methadone.
At birth, babies like Emma Lee suddenly lose their opioid supply. Some go into withdrawal and require methadone or morphine to control their symptoms until they can be weaned off.
“Her withdrawals were pretty severe,” said Amanda, who did not want her last name used, as she cradled Emma Lee in their sunny bedroom at Hope on Haven Hill. While in the hospital, the baby had difficulty eating. Her hands and legs shook with tremors.
“It was really hard as a mom to see your new baby go through that,” Amanda said. “I know for myself, I know what it feels like to withdraw, and it’s pretty terrible to imagine a tiny helpless baby going through that.”
Hope on Haven Hill does not accept active drug users. Most of the women have only recently stopped using opioids. But they cannot detox, because going through withdrawal causes dehydration and increases the risk of miscarriage or of the mother’s self-medicating with opioids to stave off the painful effects of withdrawal. So most of these women are on some kind of medication assisted treatment, either methadone or buprenorphine, which is marketed as Suboxone or Subutex.
Erica Vallee, 24, who is five months pregnant, is among those at Hope on Haven Hill on Subutex. She has used heroin since she was 18 and has been in and out of rehab and jail. She says becoming pregnant was “the only thing” that made her stop using illegal drugs.
But like others here, she is afraid of relapsing.
“I can’t be left alone because I don’t trust myself,” she said as she scrubbed the dishes in the kitchen sink after lunch.
The hope is that the stable, nurturing environment of Haven Hill will provide enough support and encouragement for these women to maintain their sobriety.
Arnold, who owns the Haven Hill house, planned the program with Kerry Norton, a prenatal nurse with whom she worked at a nearby women’s health center. About two years ago, the health center started seeing more and more pregnant women with addiction issues who were not being treated for one reason or another.
“They didn’t have prenatal care,” said Arnold, an obstetrician and gynecologist. “They’d show up at the birth center and deliver and have nothing, and their child would be taken out of their custody and they’d be out on the street again.”
Among those who showed up at the health center was Abi Lizotte. She was homeless, pregnant and had been using heroin for at least six years, after her older sister had died from an overdose. Norton, whose own son had overdosed at about the same time, took an interest in her, but Lizotte skipped appointments and Norton could not find a treatment program that would take her.
“I’m an educated nurse who knows the system, and I couldn’t navigate it,” Norton recalled. “I thought, ‘What is everyone else doing?’ And it blew my mind when I realized what everyone else was doing, which was dying.”
In June 2015, after a lengthy and exhaustive struggle, Norton got Lizotte — by this point eight months pregnant — into treatment in Nashua. That night, Norton, an insomniac, went home and took to Facebook, where she asked if anyone knew Ellen DeGeneres or Oprah Winfrey or anyone rich enough to establish a treatment program for pregnant women derailed by drugs.
Arnold, a fellow insomniac, wrote back: “I don’t know Ellen and I don’t know Oprah, but I have this house and I’ve wanted to do this same thing for three years now.”
The two started brainstorming and conceived the plan for Hope on Haven Hill. They credit Lizotte, now 24, sober and the mother of a healthy boy, as their inspiration.
Since then, they have overcome mounds of red tape, secured the home’s financing and achieved nonprofit charitable status. In September, Arnold moved her family — her husband, two children, two dogs and a cat — to a smaller home while workers renovated the Haven Hill house to meet the building codes for a residential center. Workers refinished the wide-plank pine floors, and volunteers came in with buckets of paint as new furniture, beds and linens arrived.
After a ribbon-cutting ceremony last week, Timothy Rourke, chairman of the New Hampshire Governor’s Commission on Alcohol and Drug Abuse, said in an interview that while there was much to celebrate, it was important to remember that the state is in the middle of a crisis.
“We’re still looking at a death rate that is way too high and wait lists that are way too long, and many people are asking for help that doesn’t come fast enough,” he said. “Hope on Haven Hill should be a call for all of us to do better.”
Its doors barely open, Hope on Haven Hill already has a lengthy waiting list of its own.