Methamphetamine Use in Pregnancy

Having worked in Labor and Delivery and the field of adoption, over the years I have attended many deliveries. No matter how many I see, it's still a very emotional, touching time when a child comes into the world. A couple of weeks ago, I was able to attend a delivery locally. After months of being matched, birth mom and adoptive couple were more than ready to have a baby. The delivery itself pretty much went off without a hitch. Everyone who needed to be present was there. The adoptive father just made it with less than a half hour to spare, but was there to see a beautiful baby girl enter the world. The baby who would call him "Daddy". The pictures I took of the adoptive parents holding their new baby said it all -- complete with tears of joy and shock that they had just become parents.

Right after delivery, the baby was quickly bundled up and covered to keep her warm. Once she was passed around the room and everyone had a chance to say hello, she was taken to the warmer to be unbundled, weighed, measured, and bathed. It was then that I heard the nursery nurse softly say to another nurse, "Have you ever seen that?". "No" was the answer. These were seasoned nurses and I knew that there was likely an anomaly. I made my way over to the warmer to check and see what they were talking about. This beautiful baby girl, born only moments earlier, had a condition called "microtia", in which the outer ear is not formed and there is no external auditory canal opening. Upon hearing that there was a problem, the birth mother stated, "I did this to her -- it's my fault". While everyone in the room heard the comment, it didn't register right away. Did she do this to the baby?

Earlier in the pregnancy, when the birth mom came to my office, she was excitable, fidgety, nervous, and couldn't sit still. She was scratching repeatedly and at that time I was concerned about Methamphetamine use and asked her. She stated openly that both she and the birth father had used drugs, including Methamphetamine, in the past, but that she was not using it currently. The adoptive parents and I had talked often and openly about the possibility.

After the birth, the adoptive parents wanted to get home and have the baby evaluated at the earliest possible moment and once they were free to leave the state and go home, they immediately made appointments with doctors at a medical center not far from their home, considered one of the top children's hospitals in the country. Thankfully, there are specialists there who are very experienced in treating this condition. Upon meeting with the doctor, the first question asked was "Was there Methamphetamine use during the pregnancy?".

The stats are staggering. 40% of all active drug users in the U.S. are Meth addicts. They outnumber alcoholics and pot smokers by far. Who are meth users? Anyone. Students use it to stay up late and study. It helps them stay awake and presumably to concentrate. Others just enjoy the high of being on speed. Women often try it to lose weight. You lose weight and more. You lose the ability to make rational decisions. You lose your job and your financial freedom. You can lose your family and friends. You can lose your life.

What effect does Meth us have on a developing fetus? In women who are pregnant and use Meth, risks to the fetus include premature delivery, low birth weight, cerebral infarctions (resulting from reduced blood flow to the fetal brain or by direct toxic effects), congenital anomalies (including cleft lip/palate, microcephaly, microtia, coloboma of the iris, choanal atresia, and cardiac defects). In addition, neonates affected by maternal Methamphetamine use may exhibit abnormal reflexes, extreme irritability, increased muscle tone, tremors, lethargy, poor feeding, and abnormal sleep.

We haven't seen many Meth babies, but the most common risk in using Meth during pregnancy is prematurity. When mothers use Meth during pregnancy, they can go into labor early, and it is difficult (if not impossible) to stop the early labor with traditional methods. If a baby is born too early and with insufficient lung maturity, that fact alone can cause death or many other complications.

When a baby is born with unexpected complications and an adoption is pending, there is a moment of pause and consideration for the challenges about to take place in taking care of a special needs infant. I was impressed when this couple immediately took on the challenge and never waivered, at least outwardly, in their commitment to adopt this child. Initial shock was replaced by quiet resolve. This baby will get the best medical care possible. It's going to be a bit of an uphill battle. Her surgery can't take place for years, so she must be fitted with a special band around her head which will enable her to make out sounds. Because "hearing aids" are not covered by insurance, it will be a $2,000.00 out of pocket medical expense for her parents. Certainly, this is just the beginning. But they are committed to giving their daughter a wonderful life and all of the benefits modern medicine has to offer. Mom is a nurse. I've always said that I believe there are no accidents and babies always seem to find the right home. This situation, while uncommon, is no exception. She is where she needs to be.

Methamphetamine is the most used illicit drug of our day. It is so highly addictive that we are going to see more and more people addicted over time. While studies are relatively new and there isn't a lot of long-term data, we don't know what we don't know. There may be many more complications we haven't yet seen. Alcohol has long been considered the worst drug for a gestating baby. Methamphetamine may be just as dangerous when used during critical times during pregnancy. I realize that those who are addicted are going to have a difficult time when told not to do it during pregnancy. However, if you are going to go through and entire pregnancy to preserve the life of that child and also to go through with an adoption plan with an adoptive family, remind yourself that one day of Meth use, a few drinks at the wrong time during gestation, or any exposure at all can cause irreversible damage.

Note: While researching the effects of Methamphetamine, I came across many terms that are used to put a name to the drug. The terms in use are "meth, crystal meth, speed, chalk, go fast, tina, ice crystal, and glass". Can you imagine my horror? I don't want my name associated with anything so sinister and harmful. So, if you're ever referring to "Methamphetamine", please don't call it "Tina".

Depo Provera - Birth Control or Fertility Drug?

As you might imagine in adoption, birth control and fertility issues are often topics of discussion in my world. Over the past few years, I have observed that most birth moms weren't irresponsible or careless. Their birth control method simply failed. Which method seems to fail the most? By a landslide, Depo Provera. I have often joked that with a little tweaking, it could become the next fertility drug. Whenever I am contacted by a birth mom who wants to make an adoption plan, we discuss everything - from the timing of the pregnancy and the birth father, to her future plans and birth control. Much of the time, there was an effort to prevent pregnancy. In the literature, it says that Depo Provera is 97% effective in prevention of pregnancy. I'm not sure why, then, a preponderance of birth moms who call have been on it. It would seem that the 97% figure isn't even close to the true percentages. A friend of mine went on Depo for a short period of time. She experienced one of the many listed side effects, bleeding during the course of the medication. The Depo shot is administered every three months. My friend experienced moderate bleeding for the entire three months. She said it was like having a period the whole time. So, then, it's no wonder it should be a successful form of birth control. It's not surprising that a woman wouldn't feel like participating in the kind of activities that would cause pregnancy while consistently bleeding. However, for those who are able to tolerate it and are sexually active, it seems that pregnancy is a real risk. The other side effects of Depo Provera are abdominal pain or discomfort, weight changes, headache, asthenia (weakness or fatigue), and nervousness -- all symptoms which can also be attributed to pregnancy, and which mask a pregnancy should it occur. I know a few babies who are testimony to that.

One study found an association between using Depo-Provera and higher incidence of chlamydia and gonorrhea. I'm not sure how other methods of birth control fared in terms of sexually transmitted diseases, but it's apparent that women who are on birth control seem to get a feeling of security about not getting pregnant that also crosses over to sexually transmitted diseases. Obviously, that's where condoms are a better choice. They are, according to the literature, when used correctly, almost as effective as Depo. In reality, I believe they are much safer in terms of preventing pregnancy, and certainly safer than other methods for preventing STD's.

It would be interesting to see a current research study done on unplanned pregnancies which include the forms of birth control used and the failure rates of each. In the meantime, if you want to get pregnant, try Depo Provera. It seems to work.