The Not-So-Hidden Costs of Preemie Births to Addict Moms
I was on hospital duty a few days ago when a woman in labor came into our local hospital with two very serious problems. First, she wasn't due for another 14 weeks. Second, she was a drug user, which was the reason for the early onset of labor.
Her case is a vivid example that made me reflect on the intricate (but I hope not unsolvable) relationships among health care, social problems, and economics we're facing today.
Our hospital isn't equipped to handle infants at high risk, and this baby was as high-risk as they come, so we notified Valley Children's Hospital in Madera, CA. They immediately sent a helicopter transport team to take the baby to their neonatal intensive care unit (NICU) after it was safely delivered by C-section. The team consisted of 2 respiratory technicians and 2 highly skilled nurses, an ambulance driver, an EMT (and of course the helicopter pilot).
At our hospital, the staff for the delivery required an ob-gyn, an anesthesiologist, a pediatrician (me), a surgical nurse, a nursery nurse, a respiratory therapist, and a nurse to log all the medications and procedures for billing purposes and in case something went wrong and we had to defend our actions.
All these specially trained people were required for the delivery of a 1- to1½ -pound baby boy.
Fortunately, the C-section went like clockwork, and he was transported to the NICU in stable condition. His chances of survival are very good, and he may even live a normal life if his 2 months in the NICU are uneventful. Preemies are subject to brain hemorrhage, intestinal obstruction, and renal, cardiac, and pulmonary problems based strictly on their gestational age.
Even if they survive intact enough to be discharged at 4 pounds, they require close supervision by a number of specialists in the organs mentioned above, along with a neurologist, because these kids usually have developmental delays as well.
And let's not forget why this baby was born premature in the first place - the mother's drug problem. That means that social services and child protective services are called in to protect the infant along with giving the mother counseling for her drug habit. As you can see, it has taken and will take a whole village to give this baby a chance at a normal life.
Why am I writing about this? Because by the time this infant leaves the NICU, the cost to taxpayers will be in excess of $1 to $2 million.
In most cases, infants are released to their parents, one or both of whom may continue to be addicts. It's hard enough to care for a high-risk baby under the best of circumstances. I'm a pediatrician, but even I would be hard-pressed to provide continuous around-the-clock attention if I were a parent in such a situation.
Many of these infants end up physically abused or neglected by one or both parents because the parents can't handle the stress and frustration. They don't have a life anymore except to take turns caring for their fragile baby, and they begin to blame it for all their misfortunes...
The very next day, a 20-year-old meth user presented at 26 weeks with twins! Same scenario, but times two. So in 24 hours I witnessed 3 medical cases that will cost California taxpayers between $3 and $6 million dollars this year alone!
But shouldn't we do everything to save a child, no matter the risk or the cost?
The culprit is drug abuse, another cause of our escalating health care costs. If we can put a stop to our growing drug problem, we'll be able to prevent situations like these. Drug abuse is rampant among most social and economic groups, but incarceration seems to do very little, since drugs are scarcely unknown in prisons.
However, I've been witness to one solution that seems to work very well -- adult drug court. I'm lucky to know Judge Glade Roper. He set up one of the first drug courts in California. At first I was skeptical, but over the last 10 years I've seen many people recover.
I've listened to mothers and fathers tell audiences their story of drug dependence and how they lost their children because of their addiction. After completing drug court, they were clean for the first time in many years and their kids were no longer ashamed of them. Their stories brought even the most hardened listeners to tears.
Drug court does more than cut the costs linked to incarceration. When potential moms stop using drugs, they're more likely to give birth to healthy, full-term babies instead of high-risk preemies, thereby saving the state millions on health care every year. Not to mention saving families as well.
We must keep looking for other realistic and doable ways to curb our out-of-control health dilemma and the drug problems in this country. The future for these 3 infants, born of drug use and before their time, will be bleak unless a resolution is found.
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One thing missing from the article. Many of these preemies end up costing the tax payers and school boards lots through many years of special education, therapy of all sort and medical conditions. It seems to never end.
I would bet good money that those pregnant women (and illegit fathers) are also sucking up medicaid dollars.
I advocate for all of those people receiving welfare to be on mandatory birth control and get random drug screens. If you test positive for any drug, off the so-called "program" you go.
As with these addicted women giving birth to premie babies, the same thing will continue, as long as they are getting a handout... There is absolutely NO incentive for these people to do ONE ounce of work..."if it ain't free...i don't want it!" BS! Put down you cigarettes and pay for your kids antibiotic
You forget that most women on welfare are not drug or alcohol addicts. Many are just on welfare, transitionally, because of their current circumstances. With education, back to work programs, childcare subsidies, etc most of these women would be glad to be working. And, it's cheaper in the long run to fund them now than support them forever.
It isn't just premies among drug addicts. It seems (I work where premies are referred for medical funding) that there are more premies in general. It's important that ALL pregnant women get medical monitoring throughout their pregnancies. All drug and alchohol welfare pregnant women should be monitored and required to participate in a program to help them stay clean and sober and get the healthcare they need. And I wonder if this early delivery problem isn't a manifestation of our poluted environment, the chemicals we encounter daily, and store in our bodies.
Except hard core drug addicts like this, may not even take the initiative to apply for benefits, just wait and let the hospital do it. Many women who quit working when pregnant as part of the plan in order to get medicaid take excellent care of themselves and their babies.
isn't it telling that women have to quit work and go on welfare to get medical care because there isn't another option for most working poor? this is why we need healthcare reform.
Many addicts also have mental illness which cannot even bee diagnosed until they have been off their addictive substance for approximately six months. Many mental ill persons self medicate with addictive substances, which only makes their situation worse.
We need serious care for brain illnesses which include brain injury and brain chemical imbalance as well as illnesses currently designated as "mental illness".
Many people may not be aware that physical brain injury symptoms can present as "mental illness".
How about a public health campaign to help Americans prevent brain injury? We did have some success with the public health campaign against smoking tobacco.
AND some addictive substances CAUSE mental illness symptoms. Alcohol which is legal can cause depression and/or psychosis.
In any case, babies born to parents with mental illness or addiction have problematic futures that are usually very expensive to ameliorate. We could start with really good gynecological and contraceptive care for all women and prevent problematic pregnancies. Contraception is really cost-effective.
Whoa, hold your horses there. I think this article is WAY out of line. It's a thinly disguised attack on addicted women. There are lots of preemie babies out there who have nothing at all to do with drugs, with extraordinary measures taken to save their 1 1/2 pound baby -- who is very very likely to have lifelong problems. Sure there is an issue. You ask, "But shouldn't we do everything to save a child, no matter the risk or the cost?", and the answer should sometimes be NO. How the child came to be born early is a totally separate issue.
As a non-addicted mother of an extremely premature baby who is now in adulthood, please don't link extremely premature babies and drug addicts: I left a business meeting and drove straight to the emergency room because of intense pain. It was a miscarriage in the making and those "heroic" physicians and nurses decided to play God. The neonatologist later apologized realizing his mistake ... and now, heroic nurses run from this difficult dependent child and very few physicians want to treat him. We have maximized two lifetime benefits on health care insurance; ($2 million each). Though he continues to have private health insurance, the cost is exorbitant as well the co-pays... however, I pay maximum co-pay by the end of the first quarter of each year and that helps. Meanwhile, my monthly out-of-pocket for medical supplies not covered by the insurance is pretty steep.
The laws need to change to allow parents more of say when children are born extremely premature ... Currently, it is hospital and clinicians against parents.
The response as these very complicated, sick children grow older creates isolation with less and less familial, community, church, education, and medical support.
This is a relentlessly hard plight ... and expensive.
That was my point about the article -- preemie babies and drug addition are two totally separate issues and linking them as the article does, does a major disservice to both important, but separate issues.
My sympathy is with you. And you shouldn't have to have this burdon with your health insurance. It's a wonder they haven't cancelled your policy though it's probably because you work in a large pool or for a government. If you bought privately, your insurance policy would be cancelled by now.
Your child would qualify for SSI and the US government would be covering IF your income was low enough. Many parents in this situation have to quit working to care for their child and/or to qualify for SSI and Medi-Caid, have to declare bankruptcy, lose their insurance. It's not right..
Another reason for a public program to compete with the private insurers.
This is very unfortunate. I hope the baby in this story can be ok! I, like him, was born addicted, premature and very ill. Today, I am a college graduate working for a respected publishing company. I have outlived my birth mother, brother and countless family members. It took a village and a wonderful family to raise me. It was tough, and to this day I still have lasting effects from the drug addiction and loss of my family. I hope that the village can and does step in to give him a quality of life and a chance at being someone great!
I'm glad you are okay, but many of these neonates don't end up with much of one. I did "medically fragile" foster care(I'm was an RN). It saddened me everytime that these little ones had such bad odds at leading a normal life.
A NICU (Neonatal Intensive Care Unit) Attending once explained to me, "it's a crap shoot."
It really is a crap shoot which babies do well and those who have a more complex and catastrophic outcome. My son is in the latter ...
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