Description: In the 31 years that I have been teaching courses in child development I have said a number of things that, in the face of more recent research, discussion, and intervention designs and outcomes, have turned out to have been wrong (or at least in need of adjustment). One of these is the statement that infants born to mothers who are addicted to narcotics are essentially born addicted and have to suffer the consequences of withdrawal. One of the consequences of this (not because I said it but because of the medical view of the situation) is that newborns, born to mothers addicted to narcotics have, for years, routinely been separated from their mothers almost immediately after their birth and placed in neonatal intensive care units (NICU’s). One of the consequences of this separation has been the loss, for the infant and the mother of an early opportunity to start to expand upon a relationship that has been building for 9 months. In addition, this practice has meant that the infant has lost the potential maternal connection and support for the short period of time when they are going trough the process of no longer being exposed to the narcotic their mother had been taking during pregnancy. Oh, and do NOT assume that the mothers in question are “street” users of their drugs or that they are inevitably going to be negligent parents unable to connect with their newborns – stigma, stigma everywhere! What sort of research would we need to see if we are to challenge these beliefs? Well how about an intervention that is spreading across North America that involves having these newborns room-in with their mothers in the first few days after they are born? Listen to the radio piece on this question linked below to hear about this work from the physician who put it together (and who gathered data on the effectiveness of the program).
Source: Separating newborn babies from mothers with addiction does more harm than good, says doctor, The Current, CBC Radio.
Date: March 13, 2018
Photo Credit: Rebecca Dowds, via CBC, The Current
Audio Link for the radio program piece: https://podcast-a.akamaihd.net/mp3/podcasts/current-qph4I1cU-20180313.mp3
This is a very good example of what Stigma is and how it can affect the ways in which propel are treated, even in (or especially in) the health care system. Dr. Ron Abrahams, the physician running the program, goes so far as to point out the similarities between the practice of isolating newborns from their addicted mothers at birth and the historical ugliness of residential schools for aboriginal children. A strong statement to be sure but, on the other side, the cost-benefit analyses (short term so far) suggesting a 4 to 1 advantage in rooming-in for addicted mothers of newborns are very persuasive even before you consider the basic developmental attachment and relationship formation, not to mention maternal self-efficacy considerations. As a result of listening to this story and reading about the program I have revised what I am going to say about this issue the next time I teach a birth and the newborn section of a child development course. Staying current means noticing when tings you have been saying are not just wrong but potentially contributory to problematic issues like stigmatization.
Questions for Discussion:
- Does it make sense to say that infants born to mothers who were addicted to narcotics during pregnancy are, essentially born addicted?
- How does stigmatization work in relation to addicted mothers and their newborns?
- Are there other areas where it might be worthwhile to reconsider our assumptions about people and the things they are dealing with (for example, think about harm reduction approaches to things like addicts and safe injection sites)?
References (Read Further):
Abrahams, R. R., Kelly, S. A., Payne, S., Thiessen, P. N., Mackintosh, J., & Janssen, P. A. (2007). Rooming-in compared with standard care for newborns of mothers using methadone or heroin. Canadian Family Physician, 53(10), 1722-1730. http://www.cfp.ca/content/cfp/53/10/1722.full.pdf
Wong, S., Ordean, A., Kahan, M., Gagnon, R., Hudon, L., Basso, M., … & Farine, D. (2011). Substance use in pregnancy. Journal of Obstetrics and Gynaecology Canada, 33(4), 367-384. http://www.drugsandalcohol.ie/18247/1/Substance_Use_in_Pregnancy.pdf
Hodgson, Z. G., & Abrahams, R. R. (2012). A rooming-in program to mitigate the need to treat for opiate withdrawal in the newborn. Journal of Obstetrics and Gynaecology Canada, 34(5), 475-481. http://comingsoon.jogc.com/article/S1701-2163(16)35245-8/pdf
Strauss, M. E., Lessen-Firestone, J. K., Starr Jr, R. H., & Ostrea Jr, E. M. (1975). Behavior of narcotics-addicted newborns. Child Development, 887-893.
Chasnoff, I. J. (1985). Effects of maternal narcotic vs. nonnarcotic addiction on neonatal neurobehavior and infant development. Consequences of maternal drug abuse, 84-95. https://archives.drugabuse.gov/sites/default/files/monograph59_0.pdf#page=88
Oh and wow! Morgan, M. (2004). The payment of drug addicts to increase their sterilisation rate is morally unjustified and not simply ‘a fine balance’. Journal of Obstetrics and Gynaecology, 24(2), 119-123. https://www.researchgate.net/profile/Matthew_Morgan6/publication/8884036_The_payment_of_drug_addicts_to_increase_their_sterilisation_rate_is_morally_unjustified_and_not_simply_’_A_Fine_Balance’/links/00b4951cff3728c668000000/The-payment-of-drug-addicts-to-increase-their-sterilisation-rate-is-morally-unjustified-and-not-simply-A-Fine-Balance.pdf