CHARLESTON — When Misty Woodard was 16 years old, she found her mother's body after she overdosed on Halloween.

Years later, Woodard's children almost suffered the same fate. They found their parents' lifeless bodies in their home. However, the children were able to call for help in time, and the Woodards survived.

Woodard had started using at a young age, and quitting wasn't easy. She said the compulsion to use was comparable to the need to breathe. Even when she was pregnant she couldn't get herself to stop.

"That's not something I'm proud to admit," Woodard said. "I didn't get into recovery until after my children are born; my youngest was two. They lived addiction with me."

Woodard isn't alone. About 14% of mothers in West Virginia have used some type of substance while pregnant, according to data from West Virginia Department of Health and Human Resources collected in 2017 and 2018. Nationally, that number is about 5%, according to the National Institute on Drug Abuse.

Now Woodard is clean and owns a home where she lives with her husband and children in Fayette County. She is a peer coach for Recovery Point and works with women who face the same struggle she did. She hopes her story can show them recovery is possible.

"My downfall was very loud. We were plastered all over the news for an overdose," Woodard said. "People saw that. I wanted for people to see hope as well."

Woodard and therapist LaKeisha Barron-Brown run a group therapy program called Pregnancy Connections at Thomas Memorial Hospital in South Charleston. It's for women who are pregnant or postpartum and struggle with substance abuse.

They meet twice a week - one day is a group therapy session and the other day has an education component. One week someone may come in to talk about nutrition and the next they might be writing resumes.

"It's about getting them from a life of chaos to a life of structure," Barron-Brown said. "In the life ... many things like self care, medical care, learning how to care for a baby and yourself is neglected. It's more so because of the addiction, not the person, because the addiction doesn't really allow them to focus on those needs."

It's the only program of its kind that exists in the region, Thomas Health spokesperson Paige Johnson said. There are others that are similar, but not as intensive, she said.

"I didn't know there were programs like this when I was pregnant with my children," Woodard said. "I wonder how much different my life or my mother's life would have been if we knew there was help like this out there."

Many times people hear about the program word of mouth. Other times they're referred by a doctor, Barron-Brown said.

However, doctor referrals may not be as common because medical personnel aren't always trained on how to catch addiction early on, said Jessica Hulsey Nickel, founder of the Addiction Policy Forum.

"For example, most doctors know how to spot diabetes from pediatrics to family physicians and primary care physicians," Nickel said. "If everyone has a base level of training around addiction we'll be able to identify it earlier."

In some ways West Virginia is a leader when it comes to understanding mothers and addiction. When Dr. Rahul Gupta was Commissioner of Department of Health and Human Resources' Bureau for Public Health he came up with the first standardized, statewide definition of Neonatal Abstinence Syndrome. NAS is a withdrawal syndrome that occurs after prenatal exposure to drugs is discontinued suddenly at birth.

Infants with NAS often require longer hospital stays to monitor and treat withdrawal symptoms such as tremors, feeding difficulties, excessive crying, and sensitivity to stimuli.

While Gupta was at DHHR, he, among others, started to gather data regarding the number of mothers who used substances while pregnant and children diagnosed with NAS.

Just under 4% of children in Kanawha County were diagnosed with NAS for both 2017 and 2018. That's the fourth lowest of 24 counties.

The number of mothers who used a substance while pregnant in Kanawha County jumped about 5% from 2017 to 2018. It was the second- highest county of 39 counties in 2018.

Data from counties with 10 cases or less were suppressed for privacy reasons.

Jim Jefferies, director of the DHHR's Office of Maternal, Child and Family Health, said the spike doesn't necessarily indicate an increase in drug use. It could be because the hospitals' drug screening process has changed.

West Virginia does not have a mandated maternal drug-screening program. So the data collected is self-reported from the past medical records, or drug testing, depending on the birthing hospital, Jefferies said.

However, Gupta (now the March of Dimes Chief Medical and Health Officer) cautioned against certain laws regarding mothers and addiction.

The West Virginia Legislature took up a bill in 2018 that would make it a misdemeanor to use drugs while pregnant if the mother does not seek treatment.

If the person were to refuse to enter treatment, she could be found guilty of a misdemeanor and fined up to $500.

The bill made it past the house but ultimately ended up failing. Gupta said laws like these can have a chilling effect, resulting in fewer women seeking treatment.

"Punitive measures has not worked anywhere in the country," Gupta said. "They do the opposite of the intent. They instill fear and have worse outcomes."

"You could imagine when someone is pregnant the baby is the most important element to them, even if they are in the grips of addiction," Gupta said. "They want to be able to protect their baby. Any policy even if it has the optics that it may cause issues, they will not get help."

Woodard can recall the anxiety she felt when she was pregnant and fighting addiction.

"You absolutely fear consequences. You fear CPS, judgment, what's your family going to think," Woodard said. "There are so many things that go through your mind. After my kids were taken, without recovery, I'd still be out there."

Some research indicates that women who use while pregnant tend to be in lower socioeconomic brackets and face financial struggles as well. This is why Woodard started a resource to help new mothers get some of the basic supplies they need.

"So when I got here, I saw a lot of need and hopelessness because mothers wonder: 'How am I going to provide for this child?'" Woodard said. "It's discouraging if you can't even get your child diapers."

That's when she came up with Grace's Closet, which is like a food pantry but with clothes and other items a new mother night need such as wipes, strollers, and even professional clothing for job interviews.

Woodard said she wants to bring mothers with substance abuse disorders hope, because she's been there before.

"For 20 years of my life I struggled with addiction. For the last four I celebrated recovery," Woodard said. "I come from a place of understanding and try to bring hope to let them know someone in their shoes can recover."

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