To improve the health of infants and mothers, the MGH has opened the HOPE Clinic, assisting pregnant women like Aryana Moschitto, who is recovering from substance use disorder.

Like other expectant mothers, the 25-year-old is debating names for her daughter, laughing about her baby shower and worrying about her upcoming delivery. But she’s also seeing clinicians in obstetrics, family medicine, addiction medicine, pediatrics and psychiatry, as well as a substance use recovery coach and a social worker at the HOPE (Harnessing support for Opioid and substance use disorder in Pregnancy and Early childhood) Clinic.

The integrated care model aims to help women from pregnancy through their child’s second birthday.

“I have been using since I was 13, and trying to get clean since I was 17,” says Moschitto, who is in recovery from opioid use. “But I have never had the support I have gotten through the HOPE Clinic.”

Pediatrician Davida Schiff, MD, medical director of the HOPE Clinic, says, “Pregnancy can provide a window of hope to many women who are struggling with substance use disorder. At that moment of hope, it’s critical to provide the right support that will help these women succeed.”

Jessica R. Gray, MD, HOPE Clinic’s clinical director, says the early parenting years can be very motivating for entering and maintaining recovery from opioid use.

At the clinic, the bond between mothers and infants is carefully nurtured. For example, a child experiencing withdrawal symptoms after birth can be soothed through cuddling, skin-to-skin time and breastfeeding, Schiff says. The HOPE Clinic works with parents to support their infants’ health and well-being after delivery and to promote a strong parent-child bond from the first hours of life.

“The complexity of our patients’ medical, psychological and social needs is profound,” Schiff says. The clinic’s patients are often homeless or living in residential treatment centers. They may be struggling with more than one substance use disorder. Many have been physically or psychologically abused and have ongoing legal issues.

Schiff says many patients are inspired by Katie Raftery, the HOPE Clinic’s recovery coach.

“At this clinic,” Raftery says, “we want to be more than just doctors treating a medical condition. We want to create a sense of stability and security, help them take care of their babies and build a foundation for a healthy family they can take forward on their recovery journey.”

Raftery, who has two children, says she went into recovery when she was pregnant with her son, and found it was essential to build a “tribe” of people to support her. She decided to become a recovery coach to help do the same for those like Moschitto.

“She’s always there for me to talk over things I find overwhelming,” Moschitto says. “There’s so much stigma around this disease, but in the HOPE Clinic everyone is accepting and welcoming. Jan. 6, is my ‘recovery date,’ because it’s the day I found out I was pregnant. I’m looking at life differently because someone is going to depend on me. But I also know how powerful this disease is and I am so grateful to the HOPE Clinic for helping me be vigilant with my recovery.” 



Read more articles from the 09/07/18 Hotline issue.