| I think this piece captures brilliantly the emotional and psychological toll that rote and thoughtless application of harsh procedures and mindless judgment can be wrought on people by an uncaring system. When my daughter was conceived her mother was addicted to opiates. We were both in a bad place. I was just out of a relationship with someone with Borderline Personality Disorder and she was coming out of her own abusive relationship. Needless to say this wasn't how either of us had envisioned conception. But her pregnancy was a strong motivator to turn things around. But addiction isn't something you can just switch of. Especially something like an opioid. It is extremely dangerous to the fetus for the mother to detox during pregnancy. Miscarriage is common. But that doesn't mean that treatment isn't an option. That treatment is, however, most commonly something like opioid maintenance in the form of methadone. Methadone is still an opioid (although longer acting and "harder to abuse"). It still comes with the same risk of NAS. But that risk is actually fairly low. In researching the risks around my daughter's birth I came to find that only about 1/3rd of all babies born to opiate addicted women suffered NAS, and the greatest correlation was tied to usage of multiple illicit substances (say opioids and amphetamines together) So we dedicated ourselves to having a healthy pregnancy and a healthy baby and she started methadone maintenance at a local clinic. In the end my daughter was born four weeks premature (premature birth is actual common in opioid addicts). The author of this story did an excellent job of capturing how the atmosphere changed as soon as it was discovered that my wife was under a maintenance dose of methadone. The derisive judgment. The loathing in the eyes of the nurses. That was a very new experience for me. And the procedures and policies described in the article are actually in many ways detrimental to and harmful to the outcome for the infant. Opportunities for bonding should be encouraged. And at least in the case of opiates it has been found that breastfeeding decreases the risk of NAS and should be encouraged (opiate concentration in breastmilk of a woman using opiates is measured in micrograms, far below the threshold to affect the infant, but the simple skin on skin contact and intimacy seems to make all the difference). My daughter did not suffer from NAS and after three days of observation we were discharged when it was clear her lungs were fine and she was not going to suffer withdrawals. Thankfully the attitudes of the nurses changed within about the first day. I suppose we weren't typical of "addict" parents...but I can say that being on the receiving end of that sort of experience...the only effect is going to be to push addicts further down a hole with even less chance of being healthy, functional parents. |