In the United States, where most states take a punitive approach to mothers with a history of substance abuse, addiction treatment seldom caters to pregnant women who are vulnerable to relapse and overdose during and after pregnancy. In states that have not expanded Medicaid, coverage for pregnant women expires 60 days after childbirth. Missouri almost became the exception last year when it passed a bipartisan law, House Bill 2280, to extend coverage for women with a history of substance abuse to one year after childbirth. 

The law was to go into effect in August 2018, but more than a year later, implementation is at a standstill as the Missouri Department of Health and Senior Services and the Centers for Medicare & Medicaid Services evaluate a waiver that would allow the federal government to grant Missouri flexibility with its Medicaid program. 

In partnership with “Vice News Tonight” on HBO, Reveal investigative fellow Cassandra Giraldo documented the lives of single mothers and recovering heroin users Sally Diullius and Erica Slaughter as they navigate their postpartum period in St. Louis County.

This segment originally aired Sept. 3, 2019.