Every day of her pregnancy, Daiquiri Miller used cocaine. On March 31, 2012, she gave birth to a boy.
Two days later, an Oklahoma Department of Human Services worker came to the hospital and took the child. Miller asked why it had taken so long.
Miller, 36, of Tulsa, has lost parental rights to seven children because of her drug abuse, court records show. The latest three — boys born in 2012, 2010 and 2009 — all tested positive for cocaine. During her pregnancies, Miller shunned prenatal care and continued abusing drugs, including cocaine, marijuana and alcohol.
The pattern of abuse was so egregious that Tulsa County authorities took the unusual step of charging Miller with child neglect, the first time prosecutors there had filed such a case. She pleaded guilty in July 2012 and is serving a 10-year prison sentence. Since, then Tulsa County has pursued similar child neglect charges against the mothers of two other drug-addicted newborns.
In 2012, a state law that required health professionals to report the birth of a child who tested positive for drugs to DHS was given more teeth. Now, instead of just a cursory assessment, the department is required to conduct an investigation in all such cases.
“It has given us a sense of urgency in how we collect our data and has altered our practice,” said Charlotte Kendrick, programs administrator for DHS.
In 2012, the latest year for which numbers are available, DHS reported that 322 Oklahoma newborns tested positive for drugs. Of those, 11 percent showed signs of withdrawal, which can include high-pitched crying, restlessness, jitteriness, sweating and fever. But DHS depends on medical facilities to self report and because many in rural areas don’t, Kendrick said the problem likely is underestimated.
In its report, DHS notes that mothers and newborns aren’t routinely tested. Instead, hospital staff use their judgment, looking for certain indicators, including expectant mothers arriving at a hospital far from home with no explanation, no prenatal care, premature birth or labor, self-reported or physical signs of substance abuse or a previous positive drug test during pregnancy.
The most reliable way to test a newborn for drugs is by testing its meconium, the dark, sticky stool passed by a baby soon after birth. Exposure to drugs in the previous five months can typically be detected in meconium.
According to the DHS report, most facilities send meconium samples to outside labs. By the time results are received, the baby has been discharged, complicating the opportunity to get the mother and baby help.
Though Miller is an extreme example, her case highlights some of the issues that confront those who treat babies born to drug-addicted mothers.
Often, drug-addicted mothers don’t realize they are pregnant until the fetus has already been exposed. They may avoid prenatal care, or substance abuse treatment, for fear that their baby will be taken into DHS custody, though that’s not the norm. Of the 407 investigations DHS made during the last fiscal year involving child abuse or neglect due to drug abuse, case workers recommended a child be removed in 18 percent of the cases. The figures include children of all ages and doesn’t specify whether the adult was the mother or someone else.
Sarah McAmis, director of crimes against children in the Tulsa County district attorney’s office, said she would rather not prosecute expectant mothers.
“We want those women to seek medical care and seek help for their addiction without the fear of being prosecuted,” she said.
Of 320 newborns who tested positive for drugs in the 12 months ending June 30, 2013, marijuana was the most commonly detected drug, found in 107 babies. Other drugs found included methamphetamine (77), alcohol/other (67), prescription medications (49), cocaine (17), hallucinogens (2) and heroin (1).
Prescription drug exposure is considered abuse in Oklahoma only if the mother doesn’t have a prescription for the medication detected or it wasn’t administered at the hospital.
Prescription drug exposure among newborns is on the rise.
“It’s a new wave, unfortunately, of prescription medication abuse,” said Vicki Cook, a licensed professional counselor and co-director of A Better Chance Program for drug exposed children offered through the University of Oklahoma College of Medicine’s Child Study Center. “We see a lot of methamphetamine abuse and in combination with alcohol and nicotine and some other drugs, but the prescription medications are starting to become more common.”
Because drug exposure in utero can have a lasting impact on children, the program conducts assessments, looking at a child’s cognitive development, speech and language, physical and motor skills and behavioral and medical issues.
About 250 children are assessed through the program each year, Cook said. Most tend to have more behavioral issues, so caregivers provide treatment and therapy.
“We work with a lot of foster parents,’’ Cook said. “And a lot of them are wonderful parents that end up adopting these kids, so they’re invested in them and are ready to take on the challenges they may have.”
Just 20 percent of the program’s clients are the childrens’ biological parents. More often, the program works with grandparents who are suddenly raising their grandchildren.
“They come in and go ‘It’s been 25 years since I’ve had a child in my home and now, the child is very challenging,’” Cook said.
When they see that the child is manageable and realize they can do it, it is very rewarding, she said.