Dr. Ron Abrahams wins Kaiser Foundation award

Seven mothers involved in a program that helps women with drug addictions have needlessly given their babies up to foster care in the last two weeks, says Dr. Ron Abrahams.

“If there was appropriate, safe, supportive, supervised housing in the community, these babies would not be in foster care,” he said. “What that also means is that these mothers are at risk now of going back onto the street or back into the environment that they were at because they’re separated from the babies, and that’s another additional trauma to them in their lives”.

Abrahams, who on April 24 will receive an award for his longstanding harm reduction work among Downtown Eastside mothers and their children, says the Lower Mainland needs at least 200 supportive, supervised long-term housing spaces for the women he works with, whose lives are complicated by poverty, a lack of social support, drugs and pregnancies. But he knows of only six or seven beds available in Greater Vancouver.

“Over the last five years, we’ve delivered (babies for) 500 women” said Abrahams, who provides pre and post-natal care to women in the Downtown Eastside through Sheway on East Hastings and an outpatient clinic at BC Women’s Hospital and Health Centre.

“Probably a third of the babies went into foster care. Of those third, I would say half didn’t have to go into foster care, but they went into foster care because there was no housing for the mother.”

Abrahams has applied the harm reduction model of care to drug using pregnant women in Vancouver since 1983 by working to limit the amount of drugs that mother and baby are exposed to.

Abrahams’s peers nominated him for a 2008 National Award for Excellence in Leadership from the Kaiser Foundation, which is honouring seven Canadians and organizations for their outstanding work in reducing the physical and mental harms associated with drug use and mental health problems.

Sheway provides health and social services to pregnant women and mothers with children under 18 months, who have previous or current drug use problems. Abrahams also operates a private practice.

Sheway is integrated with a program at BC Women’s. He and Sarah Payne, a midwife started the Fir Square Combined Care Unit there 15 years ago. It’s the first program in Canada to care for both drug-using women and drug-exposed newborns in a single unit.

Previously, babies were taken away from their mothers at birth and put into a quiet room with no stimulation. Abrahams said the medical community believed the women were incapable of looking after their children and that the children were unhealthy.

“Any time you take the baby away from its mother and put into a sort of abnormal environment, you’re going to get abnormal behaviour. So it’s a self fulfilling prophecy,” he said.

The babies born at the Fir Square Combined Unit stay in the same room as their moms.

His clients are addicted to heroin, cocaine or crystal meth, and alcohol may be involved in the mix. They usually have no fixed address and many have spent years living on the street. “We make sure that they get first-class prenatal care in the context of third and fourth world social conditions, which is the Downtown Eastside,” Abrahams said.

Staff try to help the women find stable housing and reduce their drug use. The hospital has 12 beds for women who need support and stabilization, before, when or after they have their babies. They can stay for a maximum of four months. Sheway also has 12 units where women can stay up to 18 months after they’ve delivered.

Mothers and babies are kept in the hospital a minimum of seven days after delivery to ensure the babies gain weight and show no signs of withdrawal. New mothers receive parenting advice from nursing staff.

Dr. Sue Harris, head of the department of family practice at BC Women’s, helped nominate Abrahams because she said he’s a “tireless leader” in a tough niche.

The Kaiser Foundation, a national organization based in West Vancouver that’s committed to promoting understanding of addiction and mental health gives each award recipient a $10,000 grant for a charity of their choice.

Abrahams will give the money to the Women’s Health Research Institute at BC Women’s so it can collect more data on the Fir Square program.

Courtesy of the Vancouver Courier Staff Writer - Cheryl Rossi