Each year, approximately 200 pregnant women are sentenced to the MCI-Framingham prison for women in Massachusetts. All of these women are considered at high risk for complications during delivery due to chrome substance abuse, HIV infection, malnutrition, and exposure to infectious disease in prison. They are also at high risk for infant morbidity and mortality as all of them deliver drug-exposed (if not drug-intoxicated) infants.
In 1989, Social Justice for Women (SJW) implemented the Neil J. Houston House, a community-based residential treatment program, as an alternative to incarceration for pregnant women and their children. The first program of its kind in the country, Houston House was designed to address the critical issue of maternal addiction in this high-risk population.
Houston House has made significant improvements in the living conditions and perinatal medical care for incarcerated pregnant women. Located in Roxbury, Massachusetts, Houston House provides aggressive substance abuse treatment, perinatal medical care, family counseling, and comprehensive resettlement services. Participants remain at Houston House for the duration of their pregnancy and a minimum of twelve weeks postpartum. After graduation, participants are required to visit Houston House twice a week for one year for follow-up counseling, drug screening, and "well-baby" check-ups.
Houston House's substance abuse treatment program includes counseling and education in a wide range of issues. Alcohol and drug addiction are addressed in relation to family dynamics, victimization and sexual abuse, health, work, leisure activities, spirituality, and socioeconomic issues of poverty and racism. Substance abuse services are based on the Alcoholics Anonymous 12-Step program with a feminist approach to recovery. Residents participate in workshops on AIDS education, racism, prenatal care, child development, parenting, and pre-conceptual planning.
Three metrics are used to measure the success of Houston House programming. The first, a sober lifestyle for program participants, is determined as a result of random drug screens and mandatory drug screens after each visit and appointments off-site. To date, of the 1,800 drug tests performed each year, no Houston House residential or outpatient participant has manifested a positive drug screen. Second, Houston house assesses infant drug-screens; of 10 children tested, all but one have mental and motor skills within normal limits, an indication of the sobriety of the mothers. Houston House also measures its program completion rates; to date, Houston House has provided services to 46 women; 8 were returned to prison for infraction of house rules; 8 escaped while still serving sentence; 13 have begun resettlement (outpatient) component; 4 have successfully completed both residency and resettlement (22 months total). Currently, there are 13 women and six infants in residence.