The call from Barker came on a Monday as I was underground in the DC metro system. I got off the train and moved above ground to better hear the program director get the facts out.
A baby was born the evening before.
Her mother was a heavy drug user.
The baby would go through detox.
Would we be interested in meeting the birth mom the next day?
My heart did a flip-flop and I remembered to take a breath and stay grounded so I could let all my preliminary training kick in, get some initial questions answered, and figure out the next step forward. The info that flowed over the next ten minutes of the call gave me a window into both the life of a birth mother in crisis, and also a preview of a series of challenges and complexities that my husband and I might face over the next few days, weeks and years.
After talking with my husband, our answer was “yes!” We were interested in moving forward. Saying that one word was fueled by months of training from Barker and consuming other adoption resources on addiction and the related challenges. It was the first step towards becoming parents to our future daughter who spent 3 weeks in the NICU withdrawing from opioid exposure.
Team Care at its Best
With a goal of decreasing both the hospital stay and medication needed, together, we all worked to minimize Baby’s suffering as we followed a consistent treatment plan.
At first, Baby was merely monitored for discomfort and symptoms of withdrawal which included poor sleep, hyperactivity, low muscle tone, irritability, increased heart and breathing rates, poor sucking reflex, and diarrhea. That monitoring resulted in a Neonatal Abstinence Syndrome (NAS) score that determined the treatment plan for the day. Medications didn’t begin on Day one, as it took several days for the withdrawal to begin.
By day three or so, the NAS score was high enough for her to begin receiving morphine every three hours and continue to increase until the scores leveled off. That was a challenging time as it was hard to see her medication dosage and discomfort getting worse and not better, but we finally arrived at a dosage to keep her stable and could then start thinking about weaning.
The nurses had scheduled “care times” every three hours at which time, together, we would change her diaper, take her temperature, give medication, and attempt a feeding before switching to the feeding tube.
Finally, one day after three weeks of ups and downs, we heard the news everyone was waiting for. She was off morphine, eating enough on her own, and it was nearly time to start out-processing. We brought the car seat the next day and after a series of checks and double-checks, she was in our car and homeward bound.
I’m so grateful that by saying “yes!” all those years ago, I had the opportunity to be that parent my child needed in the NICU as her first mother coped with her addiction. I know that my daughter may have challenges later in life, and so my husband and I will remain vigilant, but as of yet, our daughter is growing as a perfectly typical, healthy child. I understand that my part in the process is to create an environment where Baby can thrive, despite the circumstances under which she entered the world. I am hopeful that our doctors and specialists will continue to research exposure and outcomes, and in the meantime, we will continue to enjoy our daughter as she grows, and be ready for whatever comes our way.
The Silver Linings
“Wasn’t withdrawal horrible?” prospective parents often ask me when I share my story. My answer is complicated because as much as I wish my daughter never had to endure such a rough start to her life, I recognize it is only because of that crisis, that her first mother needed to make an adoption plan for her.
And perhaps it was somewhat selfish, but after years of yearning to be a parent, this was it. This was my chance to be the parent a child, my child. I didn’t want to be a parent to fill some hole in me. I wanted to be a parent to transcend, share love, and experience another part of being on this earth-- and this experience taught me more than I ever could imagine.
Here’s what I learned during those three weeks in the NICU:
1. It forced me to ADVOCATE for my child from day 1 and see myself as a critical member of my daughter’s care team- something we all need to be at one point in our children's life.
2. It helped me to RALLY MY CIRCLE OF SUPPORT rather than keep everything on my back. Since I was in the NICU all day, my family and friends outfitted the nursery and home to be baby-ready.
3. I was able to WORK REMOTELY from the NICU for longer than I might have had my daughter been home allowing more time for transition to family leave.
4. It allows for an easy path to discuss ADDICTION with my child which is something that could affect ALL families.
5. I had 3 weeks to LEARN FROM THE EXPERTS how best to care for my daughter: baths, diaper changes, feeding, etc. from the team of 24/7 brilliant and loving nurses and therapists.
6. I could take a BREAK when needed thanks to the nurses and volunteer cuddlers. Our NICU even had free snacks in the parent lounge and crafting sessions thanks to the March of Dimes.
7. I actually SLEPT through the night since I couldn’t sleepover.
8. We chose to keep the reason for her NICU stay PRIVATE and not being allowed visitors at the hospital allowed us time to feel comfortable with her story before we brought her home and introduced her to people as we felt ready. We only shared that her respiration was high, and we weren’t allowed to take her home until she was off the feeding tube--all true-- just not the whole story. In our society, addiction still comes with stigma and false assumptions. We will tell her as she is older as part of her complete adoption story, but it is her story to share as she is ready.
9. We didn’t bring her home until after the revocation period was over so we could feel SECURE with the inevitability of the adoption.
10. It was a unique and special time of LOVE and BONDING where I could rock her for hours with no distractions. In our adoption training, we learned of the importance of this time when attachment occurs. Having this quality time laid a strong base for that bond.
I have immense gratitude for the social workers who walked us through the process, the nurses who wrapped my daughter in love and care with each swaddle, the doctors and specialists who pushed forward with excellent medicine, my husband who helped us celebrate the small victories in each day, and especially my daughter, whose strong grip brought tears to my eyes each day and reminded me to hold on and keep fighting for her and our future family.
Thoughts from Barker’s Pregnancy Counselor, Sami Albert
The love this family surrounded not only their daughter with, but also the birth mother is a true testament to their commitment to providing the best care for their daughter. In the early stages of their process when they first learned of the birth mother to accepting the match, they were considering her in her moment of crisis. They immediately sprang into planning mode of how they could tap into the resources they had been provided. They reflected on the trainings they had attended, the conversations they had with their social worker, their independent research, the community resources they knew were available, and the ongoing services and support they knew they could rely on with Barker. This family considered the birth mother and the child throughout, and by doing so, they inadvertently addressed their own personal needs as soon-to-be parents; because the way that you enter a child’s life story will inevitably influence and frame the way in which you choose to parent.
As I read this parent’s account of her stay in the NICU with her daughter, and how she reflects on this time, it is apparent that this decision to love her daughter also meant a decision to love her daughter’s birth mother. Her acceptance and understanding that the birth mother’s adoption plan was a result of a crisis pregnancy and not devoid of love and empathizing with her situation was the first indicator of love, respect, and positive regard. They did not view her drug use as a ‘red flag.’ Instead, they received the information, embraced the gravity of it, and considered their capacity to parent in the unknown. I have great appreciation for the family’s decision to hold Baby’s NICU story close, and not share the reason for her stay, out of respect for both Baby and her first mother. They acknowledged the societal stigmas and ill-informed perspectives on addiction and chose to accept that this is not their story to share. It is their daughter’s. It is their daughter’s birth mother’s. Managing other people’s thoughts, perceptions, and opinions regarding the birth mother and her journey, whether well-intentioned or not, was simply a notion that they were not going to invite.
While we often look at preserving an adopted child’s birth story as respecting the adoptee and their autonomy to choose to share when they are ready, we must remember it also highlights the reverence an adoptive family has for the first family, the birth family.
We thank this adoptive family for sharing such a thoughtful account of their experience here at Barker. I am hopeful that you, the reader, will also be impacted in the way that I was, while reading in between these intimate lines and details, punctuated with hope and compassion. I hope that you will not only walk away with some practical knowledge based on their first-hand account of their NICU journey, but more so, that you will appreciate the capacity of the human spirit when we choose to lead with empathy, openness, and humility.