‘People like me don’t have babies’: Inside the clinic helping addicted expectant mums

Elvira, a 50-year-old mother of two, once believed she was unworthy of motherhood due to her heroin addiction. When she discovered she was pregnant with her first child, she told herself, “People like me don’t have babies.” But after overcoming her addiction and staying clean for more than eight years, Elvira now supports other expectant mothers struggling with substance abuse at Western Health’s Sapphire Clinic in St Albans. The clinic, located at the Joan Kirner Women and Children’s Hospital, has operated for over a year and has already assisted more than 130 women through its comprehensive, non-judgmental approach to prenatal care. The clinic offers a wide range of services, including addiction medicine, obstetrics, midwifery, perinatal psychological support, maternal-fetal monitoring, infectious disease management, dietetics, and social work. Its mission is to provide trauma-informed care tailored to the unique challenges faced by pregnant women dealing with addiction, mental health issues, or unstable living situations. Many of the women who visit the clinic share similar struggles to Elvira’s past, homelessness, substance dependence, and histories of complex mental health conditions. Elvira, who requested her surname remain private, speaks openly about the stigma surrounding addiction among mothers. “No one will ever carry as much shame and judgment as mothers in addiction,” she says. “We don’t want to be doing it.” Her role as a peer support leader allows her to connect with others who feel isolated and misunderstood. By sharing her personal journey, her battles with addiction, fleeing abusive relationships, and raising her children, she helps others begin to open up and seek help. Inside the clinic on a recent Friday morning, the atmosphere is both tense and hopeful. Associate midwife unit manager Kylie Charles moves efficiently around the clinic, managing phone calls and coordinating appointments for patients. Her goal is to minimize the logistical hurdles that often prevent these women from accessing care. “It can be really hard for some of these women to get here,” she explains. “So we want to make it as easy as possible for them.” In the waiting room, a young pregnant woman uses FaceTime to speak with her father, while another woman sits quietly, her hood drawn tightly over her head, hands resting on her swollen belly. Both are preparing to meet Dr Thileepan Naren, a GP and addiction medicine specialist who has worked extensively with Indigenous communities in regional Victoria. His experience has shaped his commitment to reducing the stigma associated with seeking healthcare while dealing with addiction. Dr Naren acknowledges the deep-seated prejudices that many of his patients face. “A lot of the women I’m seeing are used to being judged, or stigmatized, or treated poorly,” he says. “Often they don’t feel like they deserve care at all, so it’s about trying to fight against that misconception and say, ‘No, we’re here to support you and your baby.’” For some patients, the first step toward recovery involves securing stable housing. There have been instances where women arrive at the clinic having endured severe domestic violence or homelessness. For others, the immediate challenge lies in safely withdrawing from substances such as heroin, methamphetamine, alcohol, or nitrous oxide, which requires access to detoxification programs or rehabilitation facilities. The clinic’s approach emphasizes understanding and empathy, recognizing that many of these women have experienced profound trauma. Elvira notes how the women she works with initially appear guarded but gradually begin to trust and engage with the support available. “I can see them relax a little bit and then slowly they start to open up because they know I understand,” she says. The clinic’s success hinges on creating an environment where women feel safe and supported, free from judgment. This includes not only medical care but also addressing the broader social determinants of health, such as housing, nutrition, and mental well-being. As the clinic continues to grow, its model could serve as a blueprint for other regions facing similar challenges with maternal health and substance use disorders. The clinic's staff, including midwives, psychologists, and addiction specialists, work collaboratively to ensure each patient receives personalized care. Their efforts reflect a growing recognition that treating pregnant women with addiction requires more than just medical intervention, it demands compassion, community support, and systemic change. The clinic is currently expanding its outreach efforts, aiming to reach more women in crisis before they become too overwhelmed to seek help. With ongoing support from local authorities and healthcare providers, the hope is that the clinic will continue to offer a lifeline to those who might otherwise fall through the cracks of the system.