Tuesday, May 09, 2006

Pink

We had a code pink yesterday, which is the code called overhead when someone tries to abduct a baby. A mother had delivered a full term baby in the morning and no one apparently knew that earlier in her pregnancy she had tested positive for cocaine. This morning the social worker noticed that her current urine drug test showed opiates - a class of drugs that includes heroin, methadone, codeine, etc.- and informed her that her baby would have to stay at the hospital after mother went home until Protective Services checked things out. A few minutes later the social worker saw mother with her coat on and asked her where she was going. She then noticed the baby tucked in mother's coat. The mother took off down the hall, the social worker called a code pink, and the chase was on.

The mother made it through a door that is usually locked - someone had just come through it - and down a back stairway. She came out on a medical ward, punched a nurse in the jaw who tried to stop her, and headed down the stairs again. She was finally caught on the first floor in the radiology department. Her visiting privileges were revoked.

As we see in so many drug users, mother was a near "grand multip." This was her eighth pregnancy and sixth baby. None of her other children are in her custody. I don't really know what to think about her. In a way I feel sorry for her, because of her drug habit and strong unfulfilled desire to have her baby. On the other hand, I just wish she would stop having babies. Although no one said it this time, often people when confronted with a drug user having her umpteenth baby will say a comment to the effect that it's too bad we can't force such people to be sterilized. And I know how they feel. I don't want to become like China with its forced sterilizations and abortions, and am not seriously proposing that, but can't we do something to stop these people from having more babies?

I guess not.

P.S. Grand Rounds is up this week at Aetiology, and a new Pediatric Grand Rounds is at Unintelligent Design.

23 Comments:

Blogger Ex Utero said...

Hi NeoDoc,

We see these cases even in our pristine little city. Usually it is chronic alcoholism but occasionally we get a runner trying to escape child protective services from one of the the big cities (Detroit or D.C. or where ever) because of recitivism with regard to substance related child neglect or abuse.

I have to say, it's pretty hard to look at some of these individuals and not want to give them a mandatory implant of depo provera before they walk out the door. At least I would do something temporary, so that they have a chance at having children someday if they turn their lives around.

I have seen it happen once.

10:44 PM  
Blogger Cathy said...

She must have certainly been determined. Have a baby in the morning and run down all those steps in the same day. I may be getting old but I remember barely walking, let alone being in a full blown chase.

Yes, I know this isn't the focus of your post. Just an observation I made.

BTW, if you ever visit some of the policemens blog's, most of them feel the same about drug addicts having all these babies. Many of them wish there were mandatory sterilization.

1:39 AM  
Blogger NeoNurseChic said...

This comment has been removed by the author.

2:10 AM  
Anonymous MyssiAnn said...

I feel your pain, Doc, but unfortunately we can't stop them from having babies. All we can do is the best we can do for the babies once they are here and for the moms if they want the help they need.
It stinks, sometimes, taking care of patients who don't take care of themselves. It must be worse to take care of the tiny ones who didn't make the choice not to care.

4:32 AM  
Blogger Flea said...

A slight amendation to Mysiann's comment,

We can stop her from having babies, but we don't and won't stop her. We value our civil liberties and the law protects them.

It will be interesting to see when the whole country is helping to subsidize her births and take care of her kids (i.e., when single payor arrives). Will we get tougher?

I'm guessing no.

What this woman and her children need no government can provide.

best,

Flea

5:48 AM  
Blogger That Girl said...

What's really a shame is how all these women got pregnant by themselves, or by the miracle of a broken condom - oh wait. The only system we have in this country punishes the one who HAS the children, not the one who abandons them first.
I too have see crack addict moms and I have seen the effects drug addiction has on babies. Id be all for sterilization as soon as there is an equal penalty for men who abandon their children before theyre even born.
That will never happen either.

8:59 AM  
Anonymous Ariella said...

My job puts me in direct contact with people who are in the process of losing their children (I am an attorney who works for an appellate judge). There are so many women who fit the profile you've described: multiple children, none of whom are in her custody, history rife with drug problems... It is really sad and unfortunate.

Recently, I worked on appeal for a woman who had had 14 pregnancies with 13 children. This was the last of her children to be taken away from her, and she told the judge directly that if they took this child away from her, she would just get pregnant again so she could try to keep another baby. That really made me angry! She wasn't getting pregnant and considering the health or welfare of her children; just her own wants and desires.

I have this theory that if you have a history like this and are on public assistance (food stamps, welfare, medicaid, etc), then in order to be eligible for such benefits from the government, you should be on depo provera or similar. And the way this would be enforced is to condition the compliance with the hormone shots on the receipt of benefits.

Of course, it would never work because it's a sexist policy and, also, because it would be perceived as inherently discriminatory (even though, if you condition it on the receipt of bennies, it is not actually discriminatory).

Really, the only thing to do is to tout sex education and help people remember to use a condom. Or, you know, abstinence education works too...

9:07 AM  
Blogger Cathy said...

Ariella, she keeps having babies so she can stay on public assistance. these kind of people live off the govt. For some reason they think the govt. owes them a living. They get yearly raises by increasing their family size. In many states, as long as there is a child in the home under 6 yrs. old the mother doesn't have to particpate in any work or education programs.

9:58 AM  
Blogger NeoNurseChic said...

This comment has been removed by the author.

10:58 AM  
Blogger stockingup99 said...

Just wandered in, new here.

I'm appalled at the comments. That poor mother was fleeing with her baby. Birth control has nasty permanant side effects. This seems very judgmental and not compasionate.

I'm not a medical professional, just a lactating mom. The medicos treat me as poorly as code pink. Apparently breastfeeding puts babies at risk. I was forced to do extra visits sooner because a out of hospital birthed breastfed baby was considered at risk. If the medicos can be so wrong here, how can you be so sure about code pink?

Can't we help mom some way other than taking her child? Maybe a half way house for new moms.

2:27 PM  
Blogger Ex Utero said...

In response to That girl: For what it's worth, I've seen alcoholic couples in this situation where they kept having children together (despite them having been taken away because they would get so continously drunk that they'd forget to feed them for a week at a time). All of the children also had severe fetal alcohol syndrome. I wouldn't have minded snipping his vas deferens, so I don't think my harsh attitude is sexist (although I realize I have no problem with the permanence of the vasectomy decision, so maybe that's reverse sexism).

In response to Stockingup99: the real problem is that ever since Reagon stripped this country of public funding for psychiatric facilities, we don't have any resources to help people who have a proven record of harming their children via drug abuse/neglect/physical abuse. Who is going to take these people in? Which one of you want's to take that family into your home and be responsible for the welfare and safety of that at risk and very likely mentally handicapped child?

5:29 PM  
Blogger La Lubu said...

but can't we do something to stop these people from having more babies?

But the problem isn't having babies; it's being on drugs. If she were straight/sober, she probably would not have those behaviors, and probably would not have had so many babies to begin with. Drugs do destroy people. They turn good people into bad---some of them, irreparably.

I'm incensed at the talk of forced sterilization. I'm disgusted at people who think their drugs or alcohol are more important than their children, too---but forced sterilization? It has a very ugly history, folks. Women of my ethnicity were sterilized without their consent or knowledge; we were thought to be genetically undesirable. Those days are far from over. There are a lot of people who consider certain "others" to be genetically undesirable, and would love to be able to keep "them" from "breeding". I have no faith---none---that granting this power to sterilize would not be abused. Period. Let's not go there.

I've noticed a certain callousness, a certain circling-of-the-wagons mentality developing in the United States---a real "us against them" attitude. The reason forced sterilization appeals to folks is because it corrals the drug problem, in much the same way that tacitly allowing the drug problem to thrive in select neighborhoods, in order to keep drugs available for those "better off" to use them, while keeping the crime and violence that drugs bring with them safely in those same neighborhoods. Bah! I've heard so many people over the years say, "I don't care if they kill themselves on drugs---just leave me out of it."

Meanwhile, there are those of us who are supposed to withstand the slings and arrows of the drug trade, in order that wealthier others stay safe in their neighborhoods. We are the "levee" necessary that other neighborhoods are "clean". Bah.

Fact is, we could clean up the drug problem in this country. But we won't. Why? Because too many nice middle-class people enjoy using drugs, that's why. Why do you think there are harsher penalties for crack (the "poor man's cocaine") than for the snorting, rich-man's version? Shit. Forced sterilization would just be another reflection of pre-existing inequities. Hospitals or doctors wouldn't be recommending that suburban meth moms get sterilized----ever. Nahh, they'd get the Betty Ford Clinic.

Exutero: you are right about the psychiatric facilities during the Reagan administration. If we had more of those facilities, and more rehab facilities (there's a long waiting list for those who need assistance at getting off drugs), it would go a long way towards helping the problem.

And bless you, thatgirl. You are dead-on. My daughter's father has so far abandoned three children (although there may be more by now, who knows?) since he started his drug kick---no one recommends sterilization for men like him. And won't either, because he comes from a nice, white, middle-class family. People like him are given all the chances (and arrests) in the world, because people like him are assumed to be capable of "changing".

Anyone is capable of changing---or not. It's not based on their social status. Let's rid ourselves of that illusion, hm?

7:37 PM  
Blogger neon88 said...

Whoa! These are some interesting comments! "Birth control has nasty permanant side effects". Sockingup99, you didn't seriously mean that, did you? Pregnancy can have nasty side effects as well. Women can die from pregnancy. And the women we're talking about here - the ones using heroine, cocaine, alcohol - aren't worried about the side effects of BCP's or the drugs they ARE taking. And what about the babies? These drugs can cause PERMANENT side effects on them as well. Like from the moment they are born till they die. Crack can cause abruption and premature delivery and stroke. Opiates can cause lifelong developmental delay and seizures. Alcohol can knock off IQ points.
Neonursechic - I was interested to see that you send Methadone addicted babies home at 72 hours. The half life is long and withdrawal and seizures may not appear for up to 10 to 14 days. We keep these babies at least a week. I'd be interested how long NeoDoc keeps these babies.
I whole heartedly agree that the fathers get off far to easily. I think they should be made to take responsibilty. Garnish wages, withhold tax returns if they're working.
The babies are the innocent losers here and they pay the price. Methadone mothers keep their babies where I am. They are in a program and are seeking help. Moms who actively provide heroin, alcohol or cocaine to their fetus throughout pregnancy are not suitable parents and somebody needs to make sure that the most vulnerable members of our society are safe.
By the way, before I became a neonatologist I worked with drug and alcohol abusers.
neon88

10:50 PM  
Blogger NeoNurseChic said...

This comment has been removed by the author.

10:56 PM  
Anonymous Anonymous said...

I'm sorry but I'm sick of the whole "maybe having a child will help them turn their life around" idea. Please. A child is a person in his/her own right, a child is not a tool. We'd never intentionally let a drug user/child abuser adopt a child just so they could have a reason to turn their lives around.

Maybe there are happy instances when it does happen, but I bet there are alot of permanently wounded kids of folks who tried and failed or worse yet didn't try at all. I wish we had a one strike you're out policy and less socially onerous adoption policies (single parents and gay parents and parents of a different race have got to be better, maybe even a orphanage or fosterhome would be better in some cases). Poor kids.

11:10 PM  
Blogger NeoNurseChic said...

This comment has been removed by the author.

11:29 PM  
Blogger stockingup99 said...

neonursetech, since no one would allow me to leave the hospital after my second birth. I chose to birth without a hospital the next time because I think it is safer.

After the healthy drug free, IV free birth of my second child, they said I needed to stay for at least twenty four hours to recieve proper medical care. I recieved a huge rash on my butt because I was allergic to the sheets. It should be up to mom to decide what proper care is.

Proper medical care for my first birth was to inject my baby with mercury. Her newborn HEPb shot was recalled for overdosing babies with mercury.

The hospital is a dangerous disease ridden place. Getting my baby out of there was a top priority. Before those nurses could slip some formula into her.

This thread still seems pretty holier than thou, I shalt care for these poor misguided women, without allowing them to choose. I realize you are discussing addicts and not granola moms like me, but the same rules and attitudes are what pushed me away from doctors, and off to the Lay Midwives.

Yes, birth control has nasty permanant side effects, like my missing gallbladder.

8:52 AM  
Blogger NeoNurseChic said...

But see the fact that we're discussing addiction and not "granola moms" makes ALL the difference here. When you say that hospitals are a bad place and discuss the "medical treatment" as a bad thing, you don't know what you're talking about in the context of ADDICTION. Those babies can DIE without treatment. Taking an infant from the hospital when it is born addicted to drugs is EXTREMELY dangerous. They can have seizures and a whole host of other very dangerous complications if they are taken home without at least waiting in the hospital for careful monitoring.

That's why it's not the same.

I'm sorry for the bad things that happened to you, but please don't pretend these are the same things. They're not. At all.

Carrie

5:33 PM  
Anonymous maya said...

Couple comments that I can't help but make: Anonymous, was anyone here saying that having a baby might help a mom turn her life around? As far as I've seen, everyone wants the drug-addicted moms to stop having kids.

Stockingup99, you might want to check out the post on this blog entitled "Home." It's in the archives somewhere... March, I think. Some of the earlier comments are also good reading. Then again, you might just get your feelings hurt, and your experiences are of course viable. Someone really said that breastfeeding was putting your baby at higher risk? Breastfeeding has also been a recent blog subject.

I suppose I should stop acting like I own the place and shut up already. Have fun.

11:07 PM  
Blogger neonataldoc said...

Great comments, thank you. I addressed some of them in a new post. Stockingup99, the "medicos" don't determine which babies go to mom and which to foster care, the county Protective Services agency does. And not a single baby was poisoned by the thimerosal (mercury) in their immunizations.

12:39 PM  
Blogger stockingup99 said...

If not a single baby was harmed, why was it recalled due to overdosing newborn babies with mercury?

I believe my child was harmed. Each immunization made her very sick, and none were reported to the VARS database. The medico said, " I don't believe it was related", I said, "but here we are back again seven days after each shot she is returning to your office sick." Temporally related.

2:56 PM  
Anonymous Anonymous said...

I'm a nurse in a very busy hospital. Every night there is at least one drug addicted baby born, many second or third children born to teenage moms on welfare, and every so often we have a miracle infant born to a couple that has been trying to have children for years. I pray often for the answer to why so many infants are born innocent to such hardships as soon as they are concieved. The cycle never ends. You see the same women back 13 months later. It's almost as if they are like roaches. They are the most fertile people I have ever seen. I guess they have nothing better to do than do drugs, drink and have sex. Meanwhile the rest of us are working hard to make money and then see part of our paycheck go towards the 46 million americans without health insurance procreate. Family planning is like buying a car. You wouldn't buy a mercedes if you could only afford a dodge neon. Just like you wouldn't have 7 children if you could barely afford 1. It's a never ending cyle. Whether or not you believe in nature vs. nurture the children will most likely grow up and follow their parents. Sometimes I wonder what would happen if we give these women an incentive like $1000 cash for a tubal before they leave the door. Kill two birds with one stone. The woman may buy enough crack to overdose and kill herself and if she doesn't do that, at least we won't ever see the innocent results of unprotected, doped up sex. God help these children.

12:38 AM  
Anonymous Anonymous said...

So, the government will, at certain times, pay farmer NOT to grow certain crops, right? Why not do something like that? "Here's $100 for proving that your birth control implants are still in this month!" Paying women to not flood the foster care system with children for which they will be unable to care, etc. may be a way to go! It's certainly got to be more cost effective than the, what, $20k the government spends per child in foster care each year?

4:57 PM  

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