Labor Day, 2019

“Hey so I’m pregnant again and know you guys said you were done but do you want to take this baby?” Simultaneously my heart grew larger and my mind registered a truth; Larry will say no.

I’m having another child. This baby will be mine. I know that. In an instant I am a mom of 4. It’s probably the same feeling a biological mother, hoping to be pregnant, feels when the test shows two lines. The energy suddenly surging through my body is contained in my drawn legs and clasped hands, open just far enough to hold the screen of the phone I’m reading.

The words are written in Facebook Messenger. They are from Missy, the mother of my younger daughter. Her messages typically arrive only in Spring, when we coordinate our annual visit around our daughter’s birthday. And although the weather is the same now, fall in Florida is still 80 degrees, this message is very different.

Larry and I began our marriage with the purchase of a large home.We planned to fill it with 5 children, the same size family he and I were both raised in. When unprotected sex failed, we chose newborn adoption. And within four years we brought home three babies, each with different sets of biological parents. At 39 and 50 years old, three kids seemed like enough. But now, 10 years later, a new life was being presented.

Of the first 3 kids, two had not been easy. Prenatal substance exposure had caused early births, painful infant drug withdrawal, long NICU stays, specialized feeding plans, and then they became toddlers. Fetal exposure to heroin, alcohol, cocaine and fentanyl produces hyperactive and anxious nervous systems that are comfortable in fight or flight mode. These kids are resilient and smart, but live with the scars of fetal trauma along with the primal wound of adoption.

The third kid, however, with very limited substance exposure, was easy. And Missy had carried her to term. In fact, even with a substance use disorder, Missy had the ability to stay clean through a pregnancy. She had done it three times! Once she learned she was pregnant, her will took over and she did what was best for the baby. And when she was without resources to provide the life she wanted for her child, she made selfless decisions to place them with families who could. We were blessed to be one of those families.

I knew Larry would not see an opening for a fourth child in our family. He is a terrific, hands on father who quit weekend golf and nights out with the boys to be the dad he had always wanted to be. He was in the third trimester of his uber-intense career, with kids who were on sports teams and learning pre- Algebra. Returning to baby bottles and diapers was not an option for him.

And then there was the current state of our marriage; not great.Weekly date nights had ended and our last vacation alone had been a bust. It didn’t seem like the brightest idea to add another child to the mix. My brain knew this, but this baby was coming. “Give us until Monday to get back to you.” I typed this reply after delivering the news to Larry.

With a deadline in place, our conversations were frequent. Between the two of us, Larry is the salesman. He did not, however, attempt to convince me that saying no to Missy was the way to go. He simply stated, “absolutely not”. And for my part, I knew this was my child. From the second I learned of its existence, I did not falter in the knowingness of my path. I expected a difficult road with a new baby and a house full of tweens and teens, but difficult did not deter me. My road was laid out, there were no detours.

And then the road became more difficult. We (I) told Missy we would support her through her pregnancy and raise her child. I prepared our home and Larry didn’t participate. The family members and close friends in Larry’s tight circle are his world. I knew he’d make space in his heart for the new baby, who we learned was a boy, when it arrived, even without currently being on board. But it was Missy who struggled this time.

Missy’s addiction to cocaine and methamphetamines helped her deal with the extreme trauma she had lived through. As usual, she stopped using after learning of her pregnancy. Her boyfriend, and father of the baby, used opioids to deal with his tough past and current mental illness. Midway through the pregnancy, when emotions overwhelmed her substance-free mind, Missy found it easier to get relief from the same drugs her boyfriend was using. With a baby growing inside her, Missy became an opioid addict.

Larry’s anger at Missy for doing this to his unborn child was impacted by the reality of our other son’s prenatal opioid exposure. We were living with the long term effects it caused. It’s exhausting and frustrating and sad. My anger was tempered by my knowledge of early interventions that could help our new baby start life in a stronger place after going through withdrawal at birth. Our country’s opioid crisis had, by this point in 2020, given scientists a large cohort of prenatally exposed children to study.

They were discovering that Neonatal Abstinence Syndrome, the terribly painful and heartbreaking experience these babies go through at birth, was only the beginning of the impact of fetal opioid exposure. Although I wished our baby was developing in a drug-free womb, I knew the best place it could go was home with me, an experienced parent of substance-exposed kids.

I believe Missy knew that cocaine use at 8 months of pregnancy could cause placental abruption leading to spontaneous birth. So it could have been a conscious decision, after months of carrying baby Jackson. But her plan failed to include a fully charged cell phone. So when the pain of labor began, following a cocaine catalyst, Missy was alone in her rental cottage with a dead battery. Her screams of pain and cries for help went unanswered for hours in the early morning of 3/3/2020. Around 5 am, her landlord, asleep in his house nearby, awoke to her wailing voice. He found her laying in a pool of blood on her bed and called 911.

The first thing Missy asked for was a hand mirror. With it, she was able to look between her legs and see baby’s head crowning. In her mid-thirties and having experienced 3 previous vaginal births, she knew it was important to get him out and breathing. So she did. Afraid to assist, the landlord sat in the corner of the cottage repeating the Rosary.

Missy’s love for this baby kept him alive. It’s impossible to thank her for going through this for me. For us. For our family.

Missy is Jackson’s first mother. She is with me in our children every day. I hear her laugh in them, see her independence and sweet pouty lips. The ambulance arrived and helped 35 week old Jackson with his strained breathing. Otherwise, he was in good condition riding along with Missy en route to Tampa General Hospital. The landlord called me at home on the opposite side of the State. My tweens and teen and I got on the road for a 4-hour drive. They were excited to meet their baby brother. And Larry, in Texas for work, hopped on a plane to come home early and meet his second son.

We found Jackson, 6 hours old, as expected; in an incubator alone connected to monitors and a pic line with a tiny oxygen mask blocking his beautiful face. Opioid withdrawal had begun including the signature high-pitched cry, tremors and diarrhea. He was given more opioids to ease the transition and specialty care from a doctor and nurses all too familiar with these types of babies.

Before Missy left the hospital, I witnessed her painful goodbye to the child her body had carried. Love streamed down her face and hit Jackson’s soft skin. She was all he had known for 8 months. And although he couldn’t consciously feel it, her absence would create a primal wound on his soul.

I held Jackson whenever I could. I slept with him on my chest with his monitors still tracking his vital signs. The NICU was kept dark and quiet, a contrast to the NICUs my older kids had lived through which were loud and bright and incongruent to baby’s wellbeing. Ten years into the opioid crisis, medical teams had begun to adapt to calming experiences for these difficult babies. Turns out human touch does more to soothe babies and get them through the pain of withdrawal than morphine.

Jackson didn’t know who I was, but he learned. I became a constant in his life and he started to trust my touch. We spent 10 days together in the hospital while nurses changed around the clock. Larry spent several shifts with him, then drove the older kids back home. It would be the last week of school before the country shut down due to COVID-19. It wasn’t his choice, but Larry welcomed Jackson home and into his inner circle. I didn’t ask for much help with the nighttime feedings this time around, but Larry found moments to bond with our new son and offer me a break. The girls quickly fell in love with their little brother, as expected. But it was big brother Johnny’s bonding that seemed the sweetest.

I got in to see the county’s Early Intervention team on the last day of in-person appointments. The therapists felt how tight Jackson’s muscles were due his opioid exposure. His neck was cricked to the side (Torticollis) and changing his clothes

wasn’t easy due to the rigidity of his shoulders. He qualified for 2 weekly occupational therapy sessions, as well as 2 sessions with a physical therapist. Baby Jackson was healthy at every check up. His pediatrician didn’t believe the therapy he was receiving was necessary, but wrote the prescriptions anyway. After making it through withdrawal, a great many of the signs of substance exposure can be missed; muscular problems, dysregulation, gastrointestinal distress, etc. But knowing what the end result, my older son Johnny, looked like, I could see them clear as day.

Each time the therapists came to work with Jackson, I thought of how much Johnny could have benefited from these State-provided early intervention services. Where Johnny’s disconnected neurons didn’t allow him to plan well, Jackson’s brain was being reorganized through well-calculated repetitive movements. I felt the rigidity leave his body after many months of Jackson’s own uncomfortable work. Never having had the opportunity of early intervention as a baby, Johnny spent his first 10 years without the ability to fully relax. The tense muscles contributed to his constant state of fight or flight; the high alertness he first experienced as opioids flowed in and out of his fetal body. If you can imagine a moment of intense stress coupled with relentless tough demands, this was Johnny’s early childhood. A command to pick up toys is too much to handle under constant perceived stress. His difficulty regulating emotions made living with him tumultuous. His moods came on with the force of a gasoline fire and weren’t easily extinguished. And while I knew there had to be other families living this way, I felt alone.

Jackson slowly progressed, filling the gap of his developmental delays. Johnny’s maturity, age, and possibly some of the therapies and supplements we tried yielded some success. I was prepared for Jackson because of what I had learned while trying to help Johnny. But learning was tough, as society isn’t discussing the long term impacts of prenatal opioid exposure.

My best source of info is scientific reports. And the greatest source I’ve found for support, is a Facebook group. The disconnect between those with the knowledge and those who need it is curious. But rather than attempt to figure out why, I’ve begun to make the connection myself through creation of a website and national organization.

Generation O is the name I’ve given this growing group of opioid-exposed children. These kids are born with trauma and brain damage. And then, in many cases, they live in homes experiencing poverty and drug addiction. By the age of 9, only 55% are still living with their biological mother. They end up in the foster care system or being raised by a loving, but unprepared relative. Some are in adoptive homes like mine, but none of us parents have the resources we need to tell us what to expect and how to cope.

The blessing of parenting Johnny, a child born opioid exposed and raised without interventions, prepared me for Jackson. Seeing therapeutic interventions change the trajectory of Jackson’s life, inspired me to share the information all caregivers of these children need to know. My personal experience with addiction and trauma give me a unique perspective on these complicated issues. This story is written in my voice; mom, science researcher, catalyst, trauma survivor, optimist and unabashed voice of GenerationO. I hope you will find understanding and value in my story.