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After witnessing her parents suffer from addiction, Felicia Gonsalez swore she’d never touch drugs. But when her 18-year-long marriage ended in a difficult divorce, Gonsalez began dating a man who struggled with substance use and soon found herself using opioids. Within a matter of months, she lost her job, her house, and her car to her addiction. The then Pueblo resident tried to recover dozens of times over the next three and a half years, but it wasn’t until after Gonsalez gave birth to her third child in 2021 that she admitted herself into a rehabilitation program. She’s been sober ever since.
Other expectant and new moms have had a more difficult time overcoming addiction. According to a 2023 Colorado Department of Public Health and Environment report, accidental overdoses are the second-leading cause of death among pregnant women in the Centennial State, behind suicide, and in a 2023 JAMA Psychiatry study, researchers found that overdose rates in pregnant and postpartum patients older than 35 tripled nationwide between 2018 and 2021. While the reasons for the increase are unknown, the paper’s authors noted that the stigma surrounding addiction could prevent patients from seeking help.
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In January 2023, the University of Colorado College of Nursing responded to this growing crisis by launching an initiative that delivers no-cost, judgment-free assistance directly to new and future moms in the Denver metro area. The Recovery Coach Doula Program employs caregivers who themselves have survived substance use. Like traditional doulas, they prepare women for childbirth and support them during labor, but they also have another duty: to advocate for their patients’ specific needs. Gonsalez, who trained as a doula after becoming sober and joined the program’s staff this past February, recalls a recent delivery in which the nurses blamed withdrawal medication for her client’s high blood pressure. It was Gonsalez who realized the two were unrelated. “These moms already have so much guilt,” she says. “It’s our job to speak up for them.”
Care continues after birth with Gonsalez and Britt Westmoreland, the program’s coordinator and only other doula, helping mothers manage their addictions by connecting them with recovery resources, providing emotional aid, and making sure their patients have access to support groups for 12 months after delivering. That time frame is key. Patients who suffer from addiction see increased rates of overdoses for up to a year following birth, but “in a typical medical setting,” Westmoreland says, “postpartum mothers get one checkup six weeks after birth, and that’s it.”
After a successful first year that saw Gonsalez and Westmoreland assist some 40 mothers, the program is in the process of expanding to Pueblo, where drug overdose rates nearly tripled between 2001 and 2016. But until CU has the funds to hire more doulas, the pair will mostly offer virtual support there. In the meantime, they’ve partnered with Pueblo-based health care teams who attend patient deliveries on their behalf. “I always tell my clients, ‘I wish I had a me when I was going through my addiction,’ ” Gonsalez says. “It’s nice to have support and resources that you don’t know how to get when you’re in such a dark place.”
