Motherhood and Addiction Treatment: Why So Many Mothers Delay Getting Help

Key Takeaways 

• #1: Often times, mothers with substance use disorders wait longer than other women to seek help. This is usually out of fear that asking for help will trigger a child welfare report or custody case. 

• #2: Unfortunately, this often makes things significantly more dangerous for the woman that needs help and their family. 

• #3: However, many mothers put off care as a way to protect their kids and families 

• #4: Fellowship Hall places every woman into care based on a specialized/tailored clinical assessment, not a default setting. We offer a full continuum from medically managed detox through residential treatment, day and evening programs, and extended care. 

Many mothers suffer from substance use just like many other people, but they uniquely put off getting the help they need. 2Research on pregnant and parenting women with substance use disorders shows that fear of being reported to child welfare authorities is a documented reason women avoid or delay engaging with care, sometimes even when they’re worried about their own health or their child’s. When the stakes feel that high, delaying treatment can start to feel like the safer choice. It also means mothers need clear, honest information about what treatment will involve before they can feel ready to ask for help. 

This makes it even more important to understand how treatment programs address the fears, responsibilities, and practical decisions mothers bring with them. 

Why motherhood changes the decision to get help 

Being a mother shapes whether, and when, she asks.  

Researchers have found that a woman’s sense of herself as a mother directly shapes her relationship with care, sometimes delaying treatment because getting help feels like admitting she isn’t the parent she wants to be, and sometimes driving her toward treatment specifically to protect her role as a parent.1 In short, admitting they need help often feels like admitting they’re a bad mother, even though that couldn’t be further from the truth.  

The fear of losing custody doesn’t just delay care; it can outlast it.  

Losing care makes a major impact on children, and doing this doesn’t even help the mother.  When children are removed, mothers can experience worse outcomes afterward, not better, making family reunification harder to reach.2 Everything just gets harder for the whole family. 

Structural barriers add weight on top of the fear. 

When a program doesn’t account for the needs/fears of mothers, it makes it less likely mothers will join. Scheduling and caregiving demands are one of the most common reasons women delay or avoid substance use treatment altogether.3 Additionally, stigma toward mothers who use substances 4 runs deeper than the stigma aimed at women generally, rooted in the assumption that a “good mother” has complete control, which makes admitting a struggle feel like admitting failure as a parent, not just as a person. 

When viewing these together, it’s not that mothers don’t want to get help, it’s that a system is in place that makes them scared to ask for it. 

What Should Mothers Look for in a Program to Fix This? 

• Does the program talk openly about the custody question, or avoid it? A program that doesn’t discuss what treatment does and doesn’t mean for your parental rights can be a red flag. Try to get a direct answer when you directly ask. 

• Is placement based on your needs, or a fixed starting point? No person’s situation needs the same level of care, mother or not. Programs that offer individualized clinical assessments should determine whether care starts with medically managed detox, a full-day program, or something less intensive. This helps mothers and their families get the care they need. 

• Is there honest information about what family involvement looks like? A good program will be upfront about what family programming actually includes and who it is designed for, so you can plan accordingly. 

• Does staff have experience specifically with parenting mothers? A program that treats “mother” as an afterthought to “patient” is ill-equipped to handle what mothers deal with. Look for ones that understand. 

At Fellowship Hall, care starts with an individual assessment, not a default level of care. Depending on what that assessment shows, treatment can include medically managed detox, a residential treatment program, and different levels of treatment based on what the person needs.  

We also offer a Family Program, though it is important to understand what that means in practice: the program is designed for adult family members and older teenagers. Women in residential treatment step away from their young children for the duration of care. The Family Program is not a way to maintain regular contact with young children during treatment; it is a structured program for adult loved ones who want to understand the recovery process and support it. 

Fellowship Hall’s programs are also designed to treat the conditions that often accompany substance use, such as co-occurring mental health problems. For a lot of mothers, anxiety, depression, or unresolved trauma, go along with substance issues. Programs should help fix these issues by addressing them head on, not brushing them aside. 

If the fear is what’s stopping you, say that first 

You don’t owe anyone a version of yourself that has this all figured out before you call. Telling an admissions counselor “I’m scared of what this means for my kids” is a totally normal way to start the conversation about getting help, and it’s one admissions teams hear often enough to know how to answer honestly. 

Our admissions team can talk through what an assessment involves, what treatment would mean for your day-to-day role as a parent, and what arrangements other mothers have made for their children during residential care. If residential treatment is recommended, our team will be honest about what that requires, including the time away from young children, so you can make an informed decision. 

Frequently Asked Questions 

Will seeking treatment mean I lose custody of my children? 

Reaching out for help is not, by itself, worthy of a report to child welfare authorities. Seeking treatment is not the same as a custody case, and every situation is different. Go to an attorney if you have legal questions. 

What if I can’t leave my kids to go to treatment? 

This is a common question, and it is totally okay to ask an admissions team. The right level of care depends on your situation, including whether a residential setting, a day program, or another option fits what your family needs. 

Is it normal to feel like a bad mother for needing treatment? 

Yes, but it doesn’t make someone a bad mother at all, in fact, it’s the opposite. Wanting to be a good parent and needing treatment for a substance use disorder aren’t contradictions; they often exist in the same person at the same time. Programs that treat mothers with respect instead of judgment are designed with this truth. 

How do I know if I’m ready to reach out? 

You don’t have to feel ready. Reaching out for information is not a commitment to a specific program or care level; it’s just to understand what your options are. 

Sources 

• 1Adams, Z. M., Ginapp, C. M., Price, C. R., Qin, Y., Madden, L. M., Yonkers, K., & Meyer, J. P. (2021). “A good mother”: Impact of motherhood identity on women’s substance use and engagement in treatment across the lifespan. Journal of Substance Abuse Treatment. https://www.jsatjournal.com/article/S0740-5472(21)00200-2/fulltext 

• 4 Marquez-Arrico, J. E., Márquez-Arrico, C. F., & Crucelegui Lekue, I. (2026). Barriers to access and gender-specific treatment needs among women with substance use disorders: A systematic review with a gender perspective. International Journal of Mental Health and Addiction. https://doi.org/10.1007/s11469-026-01688-2 

• 2Saunt, J. V., & Montoya, C. N. (2025). Pregnant and parenting women with substance use disorders and the child welfare system in the United States of America: A scoping review. Journal of Public Health. https://link.springer.com/article/10.1007/s10389-025-02532-y 

• 3Substance Abuse and Mental Health Services Administration. (2020). Advisory: Addressing the specific needs of women for treatment of substance use disorders (based on TIP 51) (Publication No. PEP20-06-04-002). https://store.samhsa.gov/product/advisory-addressing-specific-needs-women-treatment-substance-use-disorder/pep20-06-04-002