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".

The Gender Selection Debate

My blog post a couple of days ago regarding "What to Expect When Someone Else is Expecting" generated more mail to me than I generally get from my blog posts. This is a good thing, since it gets people thinking. I think it's important for adoptive parents who are waiting to know that they are not alone, that their feelings are valid, and that they are not going crazy. The feelings they have are normal and natural under the circumstances they face. One of the things discussed that generates a little more controversy is the issue of gender selection. While it can take longer for someone to find that perfect match when are being gender specific, it's just a matter of knowing that and going into the process with realistic expectations. I want to clarify that I am supportive of our families who are gender-specific.

There are those who don't believe gender selection should be an option. When we give birth, we don't have that option. However, people want specific genders for very personal reasons. "We want a boy because we don't know if we'll ever be able to have another child and we want to carry on the name"...or "We want a girl because we have a daughter and want her to know the joy of having the close bond a sister would bring", or "We just feel that there is a boy who is meant to be in our family". There are many, many reasons someone may want to have a specific gender. As I mentioned to one of my adoptive parents recently, I actually wanted a girl every time I got pregnant. In four pregnancies, I got three boys and a tom boy. I never got the girly-girl I so desired (waiting for the grandchild who wants to play with barbies!). Would I trade any of them for a girly-girl? No, of course not, but I do understand the desire. In life, as in pregnancy, childbirth, or adoption...we sometimes have preferences. I don't think that's wrong. We have preferences in many other areas of our lives and we should acknowledge that. I think it's fine to strive for your goals. After a while of waiting, if the gender becomes less important to you, then you can change your mind and expand your options. Many of my families have done that in the past. If they truly wanted a specific gender, then that's what they went home with in the end. If their priorities changed, then whatever baby ended up in their arms was loved and wanted and the reasons that child came into the family became crystal clear.

While I don't believe it's wise to mess with mother nature in ways that could cause more problems than solutions (trying to segregate sperm before fertilization), I do believe that gender selection can be one little bonus of adopting. Adoptive parents generally have gone through a very tough process to get to where they are. They likely had infertility, failed procedures, or worse, failed pregnancies that resulted in miscarriage or fetal demise. I've been down that road and losing a child carries unimaginable grief that can't be explained in words to those who haven't experienced it. It's not easy. Then, they start the adoption process and there are additional hurdles, from expense to self-promotion. There are a lot of negatives associated with adoption from that perspective. So, if there is a positive, it's that a family can be a little more specific and end up with their dream child. I don't think there is anything wrong with that and, while it's a bit harder to find, I know that the children benefit because they are so wanted and so adored.

So, for these reasons, while gender selection can be a big challenge for adoption professionals, and some won't even try, we do. I have found, over years of personal "research", that babies tend to find their way to the right home, no matter the gender or the gender preference. If you prefer a boy and, through circumstances beyond anyone's control, you end up with a girl, you will fall in love instantly anyway. I think God's plan takes effect in adoption just as it does in giving birth -- maybe even more so. In this big puzzle of life, there is a place for each little puzzle piece and only one piece of the puzzle that fits. And while some might find that piece quickly, for others the search is long and arduous. The payoff is that, with patience, the puzzle will eventually be complete.

The Glamorization of Teen Motherhood

Often times potential adoptive parents assume that their birth mother will be a teen mom. They are surprised to learn that our average birth mom is 29 and already has two children. The teen pregnancy rate has risen since 2006 in the U.S. (in comparison to Canada, where teen pregnancy has dropped 38% since 1994). Shows on television and movies tend to glamorize teen pregnancy and in recent years there has been very little, if any, social pressure on teens to avoid pregnancy. The pregnancy of Jamie Lynn Spears of "Zoey 101" and the movie "Juno", as well as other popular celebrities have desensitized us to the down side of having a baby while still so young. Our new social norm is acceptance of teen pregnancy. In 2006, 441,832 babies were born to teen moms in the U.S. That is a staggering number. The fact is, most teen moms don't place their babies for adoption, they parent. MTV has chronicled teen pregnancy in a number of shows, including "16 and Pregnant". Their most recent reality show which showcases teens who are parents is entitled "Teen Mom". Some of the teens featured have expressed a desire to show other teens how difficult parenting is as a single teen. Typically, even those who have partners end up parenting alone after the stressors and demands of parenting cause the partners to fight and part ways. Statistics show that most teen relationships don't last, despite the intense feelings and passion.

While the teen pregnancy rate has gone up, so has the incidence of abortions. The adoption rate has gone down during the same period of time. Rather than interrupting their own teen years and their education with the responsibilities of parenthood and adult decisions, we should be promoting education to prevent pregnancy and, if it happens, adoption as an acceptable means to take responsibility for what has occurred. I would love to see adoption profiled on television, and normalized to the extent that teen pregnancy has been. While it's not good for any teen to have to experience childbirth and everything that goes with it, adoption can be a win-win-win situation, with the birth parents moving forward to their own goals, childless or infertile couples being given the opportunity to have a family, and most of all, the baby landing safely in a stable, secure place where all of their needs are met, without resentment and disrupted schedules, and with the love and devotion of, ideally, two parents who are ready to meet the day to day demands of a newborn. I am a single parent, and I am not saying that single parents can't parent well. They most definitely can. But even for those of us who do it, it's not ideal. So, we shouldn't, as a society, glamorize teen pregnancy. It's not easy and it's not fair to teen moms. I've heard parents of pregnant teens say things like "You made your bed, now you have to lie in it"...meaning that somehow going it alone is the punishment for getting pregnant in the first place. Parenting should not be a punishment. It is the hardest thing anyone will ever do, and to put that responsibility on a teen girl is asking way too much, even if she thinks it's what she wants. We need to teach our teens how to act responsibly and how to protect themselves and their education from going down a path that will be hard on them and their children. No decisions should be forced on anyone, but all options should be explored and offered. Let's not glamorize pregnancy and childbirth for children.