Five month old Valencia has chubby baby cheeks and clear brown eyes the size of saucers. She seems, always, to be cooing, saying "ma ma" and smiling – especially when mom is nearby.
"She started saying momma," says 25-year-old Amanda Hensley, adding "now at night when she wakes up that’s what I hear. Mamma, ma, ma, mama…"
Hensley hasn’t abused opioids in 9 months. She began abusing prescription pain killers in her teens and functioned for years, holding down jobs and even stopping for a bit when her now four-year-old son came along. But by the time Hensley found out last year that she was pregnant again, she couldn’t bring herself to stop. She preferred Percocet and morphine.
“It was just one thing after another, you know, I was sick with morning sickness or sick from using. So it was either I was puking from morning sickness or I was puking from being high. That’s kind of how I was able to hide it for a while," Hensley says.
When the soon-to-be baby’s father Tyrell Shepherd discovered she was using, he was worried.
"If you don’t care about yourself, have enough common decency to care about the baby you’re carrying," Shepherd sayd. "Like, be an adult. Own up to what it is you’re doing and take care of business. Regardless of how bad you’re going to feel, there’s a baby that didn’t ask to be there."
But stopping opioid use is not simple. Doctors say quitting cold turkey is dangerous for the baby and sudden withdrawal in the mother could increase the risk of preterm labor or fetal death.
At nearly 6 months pregnant, Hensley was living on couches, estranged from her son, mother and Shepherd. That’s when she reached out for help. One moment, she dialed to get her fix. The next, she called hospitals and clinics.
“Nobody wants to touch a pregnant woman with an addiction issue," Hensley says.
And there’s a reason for that, says Dr. Jennifer Bailit at MetroHealth.
"These are difficult patients, they are complicated and they have complex social needs and many practitioners are just not equipped to deal with the depth and breadth of the kind of issues that they bring with them," Bailit says.
Research finds that addicted mothers often also struggle with other psychiatric diagnosis such as anxiety or depression.
After being rejected by two hospitals and several clinics, Hensley was advised by a receptionist at one of the local drug treatment clinics to go into withdrawal so she could get treatment. She did and then went to MetroHealth’s emergency department.
The hospital, operating a state-supported program, prescribed Subutex – an opioid therapy drug that keeps a low level of opioids in Hensley’s system but doesn’t bring on the highs that result in cravings.
MetroHealth treated Hensley’s dependency as a health condition, something physicians including Dr. Stephen Patrick at Vanderbilt University’s School Of Medicine in Tennessee support.
"I think it’s time for us to reshape how we view addiction in the United States. It is a medical condition it is not a moral failing," Patrick says.
When Valencia was born, mom and baby had their own room. Nurses encouraged snuggling and breastfeeding. And they were on hand to help Hensley if Valencia’s withdrawal became severe.
"She wouldn’t latch on, we couldn’t get her to feed, I couldn’t get her to stop crying, she was very fussy and I realized, you know, I did that to her," Hensley says fighting back tears. "I took her choice away. And that’s one thing I need to work through because I still haven’t forgiven myself for that. Not at all."
Babies in withdrawal have a distinct high-pitched scream and often their legs start shaking. It’s very difficult to comfort them. To help babies manage, medical staff typically darken the room and administer liquid morphine with a dropper into their mouths.
In the months after birth, Hensley and Valencia have moved in with Shepherd. Shepherd, who was fearful the baby would come out "messed up," has taken to being a dad.
"She came out underweight. She came out 6.1 for being a full term baby," Shepherd says, adding that now "Oh, she’s amazing, she’s great."
Through the MetroHealth program, a social worker checked in with the family for months. Hensley completed intense outpatient therapy and she continues to see a MetroHealth doctor once a month to check how her daily Subutex prescription is working.
They will adjust levels, if needed.
This story is part of ideastream's new multiple media project focused on “Healthy Beginnings” is one of many topics we’re covering in our Healthy People, Healthy Places series that explores the intersection of people, place, and health. You can access all the reports at bewell.ideastream.org.