Alumni Alumni: Thais Sousa ’17, DNP ’22 changes the law with evidence uncovered in doctoral thesis

When Sousa’s doctoral thesis exposed overwhelming evidence that pointed to mothers in recovery needing an outspoken advocate, she didn’t hesitate to rise to the occasion.

With an empathetic passion for nursing, Thais Sousa ’17, DNP ’22 eagerly concluded her final year at UMass Dartmouth with more questions than answers. During her studies at UMass Dartmouth, Sousa’s doctoral thesis on mothers in recovery and substance exposed newborns took her into uncharted territory as a medical professional.

“I never worked with this population before and didn’t know much about substance use,” Sousa said, admittedly feeling out of her element. “I wanted to understand these mothers more and learn where I can make an impact.”

Sousa’s research primarily focused on why mothers in recovery suddenly relapse after giving birth, oftentimes leading to a fatal overdose. Working with women who have been sober for 3-5 years and active in rehabilitation programs, she couldn’t determine the underlying reason for their regression to drugs again. There was only one commonality among the many women she interviewed: the Department of Children and Families (DCF).

“I interviewed one mother who had a baby and was addicted to cocaine at the time. After getting that child taken away by DCF, she got clean. She never used drugs again after that and was prescribed suboxone to help with her recovery,” Sousa explained, noting that suboxone is a commonly prescribed medication given to individuals battling substance use issues.

At the time of Sousa’s research, Massachusetts state law declared that a healthcare provider must report suspected neglect or abuse of a child any time an infant is born with a “physical dependence upon an addictive drug.” This includes situations where a mother is taking a substance that has been prescribed by their doctor, like suboxone.

“When this mother decided to have another child five years later, DCF took the baby from her under the suspicion of child neglect and/or abuse two hours after giving birth,” Sousa continued. When this mother defended her sobriety and questioned DCF, they stated her child was born dependent on suboxone, but had no other drugs in its bloodstream. However, suboxone is a far cry from an illicit drug and was medically prescribed to her throughout her pregnancy by her doctor.

“Even though this mother was clean at the time of her second child’s birth, this case will stay on her record forever, and it really shouldn’t,” Sousa stated. A mother herself, Sousa considered the emotional ramifications of having a child taken away by DCF. She recognizes that this is an incredibly stressful situation for a family to endure, even if DCF closes their case.

“After I finished my thesis, I looked up the definition of neglect and abuse, but it just didn’t make any sense to me. There are some medications that you can’t stop taking, even if you’re pregnant,” Sousa said. She discovered that some women were so scarred by this experience that they stop taking their medication to treat their addictions, fearfully putting themselves at risk for relapse and posing safety concerns to the child.

Unable to shake the emotional connection to these women, Sousa leapt into action after graduating from UMass Dartmouth with her doctoral in nursing practice (DNP). State Representative Carole Fiola briefly visited one of her classes and inspired Sousa as a student with her moving words, “I am here to do work for the people. I need you to tell me what is wrong so we can fix it and make a difference.”

Without hesitation, Sousa contacted Fiola with overwhelming evidence that demanded change. To their bewilderment, they found that DCF received nearly 1,700 reports of families with infants who were born substance exposed in 2022, cases that were all-too-similar to the mothers Sousa interviewed for her thesis. Approximately half of those reports were dismissed after determining there was no reasonable cause to believe that the child was abused or neglected in any way.

Sousa, Fiola, and eight other state lawmakers filed H.166, which is designed to promote the wellbeing of families and the safety of children. This bill will modify these mandated reporting requirements and establish a system to ensure every child with prenatal exposure gets a high quality “Plan of Safe Care” and support in the critical early months of postpartum. This bill is currently going through the legislative process.

"I am grateful to Thais for bringing this issue to my attention,” said State Representative Carole Fiola. “With her research and the work done by the Mandated Reporter Commission, this issue has pulled together the Department of Public Health, the Department of Children and Families, and the Office of the Child Advocate to develop this legislation. I am proud to sponsor this bill and am grateful for Thais' advocacy."

At UMass Dartmouth, Sousa was granted a platform to freely delve into crucial matters and certainly capitalized on the opportunity to make a genuine difference in society. With the aid of prominent legal trailblazers, mothers in recovery will have the ability to reap significant benefits from Sousa’s endeavors as a blossoming scholar.