Helping Addicted Women with Beth Meyer-Frank of Planning to Flourish

Beth Meyer-Frank of Planning to Flourish Talks about Helping Addicted Women

If you are working to improve healthcare for marginalized communities, this interview is one you won’t want to miss. I had the pleasure of speaking with Beth Meyer-Frank and her work helping addicted women.

Beth has been providing health care for 25 years as a nurse practitioner in the areas of reproductive health care, addiction and psychiatry. Her work with addicted women led her to launch Planning to Flourish, which promotes awareness of the enormous power family planning has in helping addicted women rebuild their lives. You can learn more at planningtoflourish.org.

Our conversation dives into key issues, such as:

  • The unique needs of addicted women
  • How to spread a complicated message to the public
  • Upcoming changes in reproductive care and opioid addiction treatment

This is an episode of Healthcare Lead Generation with Jennifer Michelle, a podcast that mixes lead generation tips with interviews of healthcare IT disruptors, innovative healthcare providers and health sector company leaders. Follow the podcast and #HCLeadGen to learn about growth strategies and navigating change in the healthcare sector.

Helping Addicted Women with Beth Meyer-Frank of Planning to Flourish (Podcast Transcript)

Jennifer: 00:00 Hi, everyone! I’m Jennifer with MichelleMarketingStrategies.com, where I specialize in helping healthcare IT and provider organizations get more leads and reach their growth objectives. Today on Healthcare Lead Generation. We’re talking with Beth Meyer-Frank. Beth is a nurse practitioner and founder of Planning to Flourish, which can be found at planningtoflourish.org. Beth has been providing healthcare to women in a variety of settings for over 25 years. She has combined her expertise, interest, and passion in the areas of reproductive health care, addiction and psychiatry by founding her organization Planning to Flourish. The mission is to promote awareness, education, and information about why family planning should be the utmost importance as a goal for addicted women when they’re entering treatment. Beth, welcome. Welcome to the podcast. It is just such a pleasure to have you.

Beth: 00:56 Thank you for inviting me.

Jennifer: 00:58 I’m actually really excited to talk with you because I think you are really an expert in a very unusual aspect of (treatment for) substance abuse and the opioid crisis. I think you also understand it on a very deep level because you’ve worked with so many women, so I think it’s a subniche and I think your perspective is so valuable. That’s what I wanted to start talking about. For everyone listening, maybe just orient us a little bit about what some of the special needs are of addicted women because that’s a very special population of people who are in the healthcare world.

Beth: 01:40 Yes, it is. And combining family planning, which is so important. It’s such a big part of it. It’s really well recognized that women have different needs when addressing their addiction and treatment and so much so that this has evolved into what’s called gender-responsive care, which focuses on these issues. Many treatment centers have adopted this gender-responsive care and there are two really important areas of gender-responsive care that relate well to what I’m doing with my organization. And one is that we know that women experience abuse at a higher rate, and a higher rate of trauma, than men have. I know some of the statistics are 74 percent of women have experienced sexual abuse. These are addicted women. Fifty percent have experienced physical abuse … emotional abuse. And some studies say it’s as high as 80 percent and I would say it’s really 80 percent or even higher.

Jennifer: 02:52 There’s so much blaming the victim in our society of people who are addicted, but you have to kind of wonder what is going on in someone’s life that leads down that path. And I think that when you start hearing about it, it engenders so much more sympathy. And I think that’s always good for us to remember.

Beth: 03:10 Yeah. And I liked the quote, “It’s not what’s wrong with you, it’s what’s happened to you.” And I think that’s so true in the field of addiction and in the field of mental health.

Jennifer: 03:25 Absolutely. Absolutely.

Beth: 03:27 So we know that violence and trauma are real prominent in their lives and many of them have PTSD. So the other important area with gender-responsive care is women are usually the likely caregivers of their dependent children. And there’s often a lack of father involvement. If I may, I’d like to give you an example that kind of illustrates this. I’ll call her Angela. She’s 29 years old. She has methamphetamine abuse. She’s had 11 pregnancies, her children, she has a 15-year-old, two 10-year-olds – because they were nine months apart – a six-year-old, four-year-old twins and an eight-month-old.

Jennifer: 04:16 Oh my God.

Beth: 04:17 Yeah. There are five different fathers, but none are involved. She’s letting her aunt adopt the baby, her mother-in-law has custody of the other children, but she doesn’t want another pregnancy “right now. ” And, as we look at that example, I know it sounds shocking, but it’s really a common scenario that I see over and over and over. And some of the common themes are, again, violence and trauma has played a part. Multiple repeat pregnancies and loss of children out of care placement, often to foster care, and multiple caregivers is common. So if we look at these issues and we looked back at Angela and we think, wow, if we had just been able to somehow help her after she’d had even one 10-year-old, and she had had some contraception and family planning and spaced her children out, she might be able to have custody of at least a couple of her children before she went on to have more.

Jennifer: 05:28 Yeah. Let me ask you this before we go into that a little more. Just to be clear. Gender-responsive care, is that a specific kind of of substance abuse treatment that is designed to understand the different intersections of gender and abuse and all of those aspects that you’re talking about? Is that what it is?

Beth: 05:50 Yes, it involves several different principals. One is just making the staff aware that women have some special needs in these areas, in this area of trauma and violence. So they, perhaps, are not going to be comfortable in mixed groups, One is setting up a safe environment where they’re going to be in treatment. Maybe not interacting so much with the male population and just boundary issues, which are always a big issue and looking at relationships and community services like, we’re going to talk about that with family planning, support in the community, jobs, skills, that sort of thing. So it’s more a mindset, just like trauma-informed care is the same way. It’s taking into consideration all these differences and how we have to just be really aware of that sort of thing with women and what their comfort level is. Also, and I just read an article today about just maybe moms having their own group also because again, they have to be able to relate with each other. In addiction, one of the biggest, most important things is connection. And I hear that over and over and over again. I see that with my cases. It’s the empathy and connection that’s so important. I think.

Jennifer: 07:22 You know, I find that is so often the case with any traumatized person in any situation. I think that is what people are seeking because that is what you need to heal. I don’t know if this relates to it. Many years ago I used to volunteer with an organization that helped street sex workers with their healthcare and they worked, obviously, with a lot of the addicted population, though not exclusively. And they talked a lot about harm reduction. Is that part of this approach or is that a separate thing?

Beth: 07:53 I think it’s all integrated together. It’s got a different focus with harm reduction. It’s providing care that some may not find acceptable. People may continue to use, but we try and do the best you can for people without a lot of judgment and stigma, and you kind of meet them where they’re at in their recovery. So it kind of intersects, really, because it is such a complex issue.

Jennifer: 08:26 And what is going on that there is no help with getting family planning to this population? If you’re talking someone who’s had that many pregnancies and as many troubles, is it that there’s no access? Is no one in talking to them about it before you? Where is the hole there in that situation?

Beth: 08:45 That’s a good question. Part of the problem, I think, is just that addiction is so complicated that when women go into treatment, there’s so many issues that they have and the workers at treatment programs don’t have any special expertise in family planning. Like, for example, I’m fortunate to have. So we all look at that situation with Angela or any woman who’s trying to seek reunification with children out of their care. And we all look at each other and say, “Oh my God, pregnancy at this time, why?” But there are so many more issues involved in this. It’s complicated. I had a patient who had five children and she said, “I want to get pregnant again because I’ve lost all my children.” So it’s a feeling. It’s filling an emptiness and hoping for a different outcome, without any changes made and thinking this time it will be different. There’s a study that was done in Seattle that showed that women who have lost children to care placement are at higher risk of getting pregnant again while they’re in treatment.

Jennifer: 10:03 I would think that it’s even deeper than that because it’s not just the retraumatization – and tell me if I’m wrong on this – but it’s not just the retraumatization of losing that child and wanting the next child. I am guessing that, for a large number of these women, they need that original nurturing, so that’s what they’re seeking. They’re seeking a situation that they hope will nurture them and so the ripping away of their child is probably even a greater pain because it is ripping that open and they’ve never gotten the connection you just mentioned, which is what I’m sure that they need most of all.

Beth: 10:38 Yeah. I’ve heard that over and over again from many addicted women. “Well, I hope that this baby’s going to love me” rather than, you know, that’s not the purpose of motherhood.

Jennifer: 10:49 Right. And they don’t understand that because they just need that great love. They need a maternal love or a parental love, I guess is a more accurate way of saying it, and they maybe never got that.

Beth: 11:00 Yeah, they’ve never had it. I’m a big believer in the attachment theory. We know that healthy attachment starts in infancy and that’s what helps children regulate their emotions and think logistically and to be able to develop a conscience and self-reliance and handle their fears. And we know that if they don’t have that attachment, they’re not going to develop that. Of course, healthy, attached children means healthy adults and healthy adults can regulate their emotions. They don’t engage in self-destructive behavior, such as substance abuse.

Jennifer: 11:39 No. They think they’re worth something become someone bonded to them.

Beth: 11:42 Right, exactly. It’s all about, I believe, attachment and self-esteem and self-worth and that’s what a lot of women are looking for. Why they continued to have pregnancies thinking that’s going to happen for them and they’ve never had that.

Jennifer: 12:00 Wow. That’s something that I think, for me, and I’m guessing for many of the listeners here, it’s something that we don’t think about often enough. We don’t really understand what is going on there. And when you read the headlines about opioid addiction and substance abuse and where that is headed, it’s just so easy to lose sight of the people involved and why people are getting lost in this and what’s happened to them to bring them to that. It’s just very powerful to hear you talk about it. I’m curious to know, personally, what made you direct your career towards this particular population and work with women who are addicted?

Beth: 12:45 Well, it was kind of serendipitous, really. After being a healthcare provider for so many years to really vulnerable populations – homeless women, migrant women, teenagers – I had very little insight into the problem with repeat, unplanned pregnancies and addicted women. And I think it’s true of a lot of family planning professionals. They just don’t realize when they talk about family planning and contraception, they make it so – I guess clean is the way to say it. You know, like middle class. Except for the teenagers, maybe. They don’t realize how many children are lost to the system. And we know that, in foster care, there’s almost 500,000 kids in foster care in the United States. When I saw that number, I thought, oh my God, I can’t believe that. 500,000, half a million kids in foster care, and we know that these kids do not have good outcomes. They have a high rate of substance abuse. So. So my whole thing is trying to break that cycle of addiction on the front end of it, by preventing these pregnancies because the outcome will not be good for the kids or the mom. Because you can imagine the shame and devastation from losing one child, much less more than one. And being re-traumatized over and over again. And then the children do not have good outcomes, with incarceration and substance abuse.

Jennifer: 14:27 Of course, and that lack of attachment goes on because, the more you learn about toxic stress, which this is a form of, the response it creates in the mother is then passed on to the child. It’s the baseline for stress is then much higher. So that lack of attachment would get passed on, I am sure.

Beth: 14:52 And many of these children have multiple caregivers, you know, with distant relatives or friends they’re placed with or they’ve had multiple foster care placements. And one statistic that just shocked me was that females in foster care, 50 percent of those get pregnant by age 19. So these are young females that have probably had more trauma than most, being in foster care, and had no real parenting skills and they’re very young anyway and yet they get pregnant and probably continue with the pregnancy.

Jennifer: 15:32 Wow. let’s bring this back. That gives everyone, me included, a very detailed idea of what we’re talking about with this population and what Planning to Flourish is working with. So, since I do always focus this on marketing, since that is what the podcast talks about, I’m curious, how are you getting your message out? Because this is not an easy message to receive. And that’s something that is a little different about marketing in the healthcare world – you’re not always trying to get out a message that is fun and wonderful. Like the new Starbucks flavor. It’s a message that’s not pumpkin spice. It’s something that is so complicated for people in our culture to receive. You’re talking addiction, which we are taught as a culture, that this population is more expendable than others. It’s women and, obviously, that’s a group that is often dismissed. And then you’re talking about family planning, which is very, very conflicted in our culture. So how are you getting your message out and what kind of response are you finding?

Beth: 16:43 Well, one thing I was doing to start, aside from my website and my Facebook page, is just talking about it. How family planning and contraception are so important on the front end, at the very beginning when women go into treatment. So I’m doing local presentations. I’ve done some national and international speaking to child welfare groups, addiction professionals, family planning professionals and stressing what we’ve talked about already, with some of the numbers and the situations, but also that contraception is really at the base. The basic component of family planning but it’s only one component. We know that women who don’t use birth control for a year, 85 percent of them will be pregnant and that’s why we see these multiple pregnancies, such as Angela. The example I gave you is because women are out using substances and they don’t think about it. If they’re not using birth control, 85 percent of them are going to get pregnant.

Jennifer: 17:52 That’s what young women’s bodies do.

Beth: 17:54 Right. And we have very effective, long-acting, reversible contraceptives that require no user action to maintain, that are really ideal for this population. Because if you think about it, women and men, the trauma part of it takes a long time. Just the brain chemistry. Getting back to normal. Being in treatment doesn’t happen overnight and suddenly you’re cured. We know that it’s a relapsing disease. We also know that a lot of women will leave treatment soon after they enter in. A lot of times they’ll come back pregnant when they start treatment again, which is a lot of times what brings them into treatment.

Jennifer: 18:37 So I’m curious about this. So much of the work that I do is helping organizations find their message and, as we’re saying, your message is heavy hitting. It’s this stuff you don’t want to talk about, this thing no one is looking at. And that’s always harder, though, I think it can be very impactful once you do start finding a way to focus people’s attention on what you’re doing. I’m curious on two different levels. One, how are the women who have the addiction receiving this from you and, two, how are the other organizations, the other nurses, the other healthcare professionals, receiving it?

Beth: 19:16 I think, overall everybody is dealing with the same problem but aren’t really thinking about it as being in and of itself the most important thing, or one of the most important components. Which of course, because of my background, I see it as being very, very important. The focus in the programs has been more on pregnant women and parenting skills, which is how it should be, but I just feel like we should, right at the beginning, try and really focus on the contraception. When you read about it, you just don’t hear about family planning being mentioned that much. We look at a lot of the areas that are part of family planning because it includes childcare and support systems and getting medical care for the patients. Many of them have hepatitis C, they have horrible dental decay, lung disease from smoking, housing issues are huge. Education and job skills. The children’s medical issues, all these things play a part in family planning. So the other thing I’m doing besides the presentations, promoting awareness, is I’m implementing soon where I work – I work in an opioid treatment program – a pilot. My pilot project, which is called Insight Information and Incentives for Women in Recovery, and the purpose is to provide motivation to addicted women to postpone their pregnancy until they’re stable in their recovery and can parent their existing children. And I say existing children, but because so many women are trying to reunify with with children out of their care. This takes a lot of energy to do this and if you add another pregnancy while you’re in treatment while you’re trying to reunify, many times those kids that are out of their care are just left there and reunification never occurs.

Jennifer: 21:25 How does the reunification work? Is that often successful or is that often just leading to more separation of the parents and child later?

Beth: 21:34 It can be successful. It depends, again, how motivated the woman is to to be reunited. Whether she’ll stay on treatment. We have a lot of drug courts throughout the country that work with women so that they can reunify with their children. I’m all for trying to reunify the women and their kids because I think this is the best outcome, but the women, of course, have to be able to parent. And part of my pilot project is to provide some basic information about birth control, but also to do some insight training through an insight journal that I’ve developed called the Pregnancy Life Plan. And it’s for women while they’re in treatment to write about, do collages about – because women in recovery love to do pictures about each segment of the family planning that I mentioned, such as who is there child care and support system, what are the medical needs of their children? Do they have a lot of medical needs for their existing children that are going to take a lot of time? And special needs – we know that these children, because of the trauma, do have. Do they have a lot of medical care for themselves? Do they need Hep C treatment? Do they need mental health care? Maybe they’d been off their psychiatric meds and do they need to get back? So it’s kind of looking at the whole picture by throughout this journal of where they are at. What their goals are for themselves, what their jobs skills are, what their goals are for their children. Because I find that a lot of the women, they go out and they’re using, they just get pregnant, but it’s really kind of looking at the whole picture through this journaling process.

Jennifer: 23:25 So the journaling then, in the pilot project, is there a specific end point that you’re measuring or is it kind of an ongoing program? How is the pilot project set up?

Beth: 23:36 It’s actually aet up so that there’s two meetings. One is to do the information and to give the journal and then the woman could share the journal with her counselor, with groups – we see in treatment programs that groups are very prominent. All kinds of groups, anger management, parenting, so they will complete that. And also it includes giving them incentives so when they go out and get a women’s health care exam, which a lot of them have ignored unless they are pregnant, if they get any kind of a contraceptive, then they will also get an incentive in the form of a voucher, like a gift card. So that’s the incentive part, because my feeling is they need the inside, but many women just need that extra push because I believe that a lot of them really know deep down that they shouldn’t get pregnant again, that it’s not the right time, that they’re worried about losing another child or that they can’t take care of that child, but they don’t have the push or the motivation because they’re so overwhelmed with all the other problems to follow up and go get a birth control method. So this would give them that incentive. But we use contingency management all the time in addiction treatment, such as when they do their counseling, they get food gift cards or, if they’ve completed certain certain levels of treatment, they get rewards.

Jennifer: 25:10 Is that what contingency management is? That’s not a term I’m familiar with.

Beth: 25:15 Contingency management, is that, yes. They get some type of an incentive for completing something and you use it also for weight loss and rewards that way. You see it used in smoking cessation … I think the French had a program where they gave cash to pregnant women that stopped smoking. You see it in lots of different programs in the criminal justice arena. Also with adolescents, you see contingency management, which just means giving some type of an incentive or reward for completing something.

Jennifer: 25:54 No, I can see that.

Beth: 25:55 I really believe it’ll work. After working with thousands of women in all different kinds of settings, outpatient, residential, opiate addiction, I really feel like it would work.

Jennifer: 26:10 So how long is the pilot going to be going on?

Beth: 26:14 It is ready to be implemented. I want to just start small and get the first 20 women and just see how it goes. We’re measuring how much the incentive plays a part and how much the insight journal also helps. It’s a qualitative study.

Jennifer: 26:32 That can be very important.

Beth: 26:34 Yes. Very informative. And then that gives me more data to to say, hey, this is something we can replicate in other recovery programs.

Jennifer: 26:44 So the idea then would be, once you know whether it’s working and what part is working well, to then scale it up for more projects?

Beth: 26:53 That’s right. I really see it working in all different levels and kinds of programs, whether it’s jail or whether it’s transitional living facilities, which are also called sober living facilities, residential programs, outpatient programs. It really could work in any. Because in all of those programs we’re really dealing with the same issue. You know, we’re trying to break that cycle of addiction by allowing women to really be successful in their sobriety, be able to reunify with their children or parents or existing children and decrease the trauma and not have yet another pregnancy and another traumatized child. And more trauma to the mom.

Jennifer: 27:39 Absolutely. Let’s talk a little bit about what is coming over the next 12 months because I want to see if we can explain to people who are listening a little bit about the different factors that impact this area. So, are there political impacts, are there certain things regarding treatment going on? I would think, right now, politically, there are a lot of pushes that might impact reproductive care. Obviously right now in the US, that is a huge issue. I just want to get your thoughts on some of this. I think, for all women, but I think especially for these very vulnerable populations of women, I think it’s a big issue.

Beth: 28:18 Yes, it definitely is. And I think another thing, if you visit my Facebook page, one of my favorite things to do is post from a lot of legitimate groups that are doing really wonderful work in a lot of the areas that we’ve been discussing here. And one thing that’s very important right now is reproductive care access. With the current administration, there are so many limitations and such an assault on women’s healthcare and this really affects low income women. And addicted women certainly fall into that and have so many other needs. So this involves funding cuts to Title 10 clinics, which provide contraceptive care, not abortion care at all, but contraceptive care in many areas where that’s all women have. In California, we’re lucky enough to that Medicaid covers contraceptive care and we have a family planning program. But in some states, the women aren’t so lucky.

Jennifer: 29:26 Absolutely.

Beth: 29:27 Also Roe v Wade, the abortion access, there are all kinds of restrictions.

Jennifer: 29:34 I keep thinking that if people restrict that, even though the majority of people in this country very much support a woman’s right to choose, I think that it’s going to be a slippery slope and IUDs will be banned or there’ll be motions for that. I think Plan B will be under attack and I think it’s a very slippery slope and that is where I hear it going. One thing, I am not seeing your Facebook page linked on your website. Can you tell us where to find your Facebook page for anyone listening who wants to?

Beth: 30:09 If you just go on Facebook and just search Planning to Flourish, my Facebook page will come up. I have lots of really interesting, great organizations. Some of my favorites are The Guttmacher Institute.

Jennifer: 30:28 Great data around reproductive health care.

Beth: 30:31 The Chronicle for Social Change talks a lot about child welfare. Planned Parenthood, several addiction websites for professionals and others that also do a lot of interesting work. It’s really very educational. So I try and go through and link to those on my Facebook page.

Jennifer: 31:01 Wonderful.

Beth: 31:03 The other thing I wanted to talk about that has been important is, of course, the opioid epidemic. We’ve all heard of that, although methamphetamine use on this side of the United States is also huge. We know that in 2015, 33,000 Americans died of opioid overdose. That’s 91 Americans a day. That increased to 64,000 in 2016 and I think I read yesterday to 72,000 in 2017. If you look at this and you think about parents losing their children, losing their parents, then again, it’s another trauma. And I always think of that with overdoses.

Jennifer: 31:53 Who are the children being left behind from that.

Beth: 31:56 Exactly.

Jennifer: 31:57 I think that’s the thing most people don’t think about. They think of it as an individual person and it’s usually considered to be an individual who made a bad choice and that’s what happens. I think it makes it easy for people to wash their hands of it and move on, which is what has been the response to this. But you’re really seeing it as, these are families that are being traumatized and it goes on into the next generation.

Beth: 32:24 Yeah. Because a lot of my patients have lost parents to overdose a lot, really all the time. So it makes me realize that’s a trauma that stays with you. And then the other thing I think we’re going to see is with the medication-assisted treatment like Methadone and Buprenorphine. Which is what I do in my practice every day. We’re going to be reducing the stigma around that because we’ve just realized that the way to treat opioid addiction is a combination of medication and, of course, counseling and intensive treatment.

Jennifer: 33:07 And is that a new trend that you’ve seen? I don’t know enough about the treatment. If you could walk me through a little of that, I think that would be very helpful.

Beth: 33:16 It’s a long-acting opiate that’s been used for years and years for opioid addiction. That and Buprenorphine, also called Suboxone, are the two medications that will decrease withdrawal symptoms and cravings and allow people to really stop using opioids. Otherwise it’s a very, very uncomfortable withdrawal and people just can’t get beyond it on their own. They need the medication to help with that so that they can start getting their life back together, start getting out of the habit of using and also get the counseling. And everything else that they need and there’s still a lot of stigma around this and but I think we’re seeing more medication-assisted treatment centers opening up and they’ve expanded practice for prescribing for both of these medications. So we’re toing to see more and more of that.

Jennifer: 34:18 It is so interesting. I was surprised when I read a little bit about how opioids work on the brain and – I’m obviously no expert on this – but the way it blocks up your receptors so that it becomes extremely hard to feel general contentment or pleasure in your day without that assistance. And the way it reconfigures how your brain is wired, so to speak, in a way that people were not understanding. Suddenly that makes it a lot easier to understand why the cravings are so intense.

Beth: 34:53 Right, and they continue to be intense just because of that reward center and that lack of dopamine in the brain. And this takes a long time to get back to normal, maybe a year to two years. So I always stress that with patients, all the more important to be on some medication that can help them with these cravings. Also while they’re getting the counseling and help they need.

Jennifer: 35:18 Where do you see this going? A pet interest of mine is the adverse childhood experiences and toxic stress issue that people have been speaking about so much more in the last year, thanks to the work of Dr. Burke Harris. I think one of the things that is interesting about what you’re doing is that you’re seeing it as an issue for the children, but you’re also saying, you know, this doesn’t disappear when you turn 18. These women still have these issues that have not been treated. And I think that’s tremendously helpful because the original study that was in the nineties and it was some 60 odd percent of people who did not seem to be having particular problems, but had high levels of ACEs. And these were adults and now the focus is on screening for children. Which is great because it’s so important to help them grow up and be healthier, but for those people who’ve already grown up, what kind of help is out there for them? And are you finding people are more receptive to giving the kind of care that is needed here? I think you, obviously, are but is the system adapting to that because it is a different approach to say this is toxic stress and this is a bigger issue than what it appears on the surface.

Beth: 36:31 Yes, and I was lucky enough to hear Nadine Burke Harris speak recently.

Jennifer: 36:38 Oh, I’m so jealous.

Beth: 36:39 Yeah, she’s a great speaker and she’s doing great work and really brought to the forefront the whole ACE study, which was like you said, done in the nineties with Kaiser patients.

Jennifer: 36:49 Right. But just buried so nobody even really knew about it.

Beth: 36:52 For 17,000 participants and, like you said, it was a really more of a middle class population. So that’s one thing that’s a big part of my presentations – the ACEs, the adverse childhood experiences. These are abuse, neglect, substance abuse, violence towards the mother in the home, a loss of a parent for any reason, mental illness or criminal behavior in the household. When you look at addicted women, they have such high ACE scores and, of course, their kids are going to have them, too. When kids are going into treatment with moms, they’ve already had probably a least two or three adverse childhood experiences. My goal is to hit it again on the front end and have the women treated for trauma, which I think it is in the forefront now with trauma-informed care, and then to prevent – until that woman gets treated for trauma – to prevent having more kids that are also going to be traumatized when they’re separated from their mom.

Jennifer: 38:02 Plus it helps the woman address the real issue, which is you need to be cared for, for your trauma, not have a baby and hope that that heals it.

Beth: 38:11 Exactly. Yeah, and that’s a big part of treatment for sure.

Jennifer: 38:15 Beth, it has just been wonderful to talk with you about this. Thank you so much for coming on this podcast. I think it was so informative. It is wonderful to see that you are starting a pilot project that is helping this very, very important group that has not been getting enough attention. I love to see that. So thank you for coming on the podcast.

Beth: 38:38 Thank you for having me.

Jennifer: 38:38 Absolutely, and for everyone listening, you can learn more about Beth’s work at planningtoflourish.org. Beth has been providing healthcare to women in a variety of settings for over 25 years. She has expertise in reproductive health care, addiction, psychiatry, and that’s what led her to found Planning to Flourish. The mission of her organization is to promote awareness, education, and information about why family planning should be of the utmost importance as a goal for addicted women when they enter treatment. So thank you again, Beth, and, for everyone listening, I’m Jennifer Michelle of MichelleMarketingStrategies.com, where I specialize in helping healthcare IT and provider organizations get more leads and reach their growth objectives. Catch you all next time!