“Dr. Iqbal, are we really going to follow up and keep her in our practice? She’s a heroin addict and she’s going to be using again this pregnancy. She never went to any rehab or took any suboxone!”
I asked our nurse what she knew about the patient other than what she obtained in triage. She replied that it was all she knew, so I told her the rest of the story.
“I am going to do everything right with this one and make sure I get to keep her! I have to!” Jamie exclaimed as I took her history. She told me that at the time of her previous pregnancy, she had been a heroin user for six years and continued to do so even after she found out she was pregnant. It did not occur to her that it could affect the fetus inside her. She received no prenatal care and delivered prematurely to a 3-pound girl with remarkably no complications.
After months in the NICU, Jamie was surprised when CPS and DSS placed her infant in foster care. Both her urine and infant’s urine had come out positive for heroin. She was further surprised when she could not breastfeed her baby.
Having her child in foster care was the proverbial wake-up call for Jamie. She voluntarily disposed all her syringes and heroin at the police station the week following her discharge. She removed herself from her circle of friends who were using and made arrangements to visit her child. She did not go to rehab; she said her daughter was all the motivation she needed. For two years, she drove two hours each day to see her daughter with the foster family.
When she discovered she was pregnant this time, she was determined to keep her child and made it a mission to have as “normal” a pregnancy as possible: prenatal care, with regular visits and a birth plan.
Expressing shock at her story, I asked how she was able to recover without any help. Jamie smiled and said: “Love is all you need! And I am going to make it right this time!” I replied in the affirmative as I scheduled her for upcoming ultrasound appointment at twelve weeks.
Kingston, New York