Five month old Valencia has chubby baby cheeks and clear brown eyes the size of saucers. She seems, always, to be cooing, saying "ma ma" and smiling 鈥� especially when mom is nearby.
"She started saying momma," says 25-year-old Amanda Hensley, adding "now at night when she wakes up that鈥檚 what I hear. Mamma, ma, ma, mama鈥�"
Hensley hasn鈥檛 abused opioids in 9 months. She began abusing prescription pain killers in her teens and functioned for years, holding down jobs and even stopping for a bit when her now four-year-old son came along. But by the time Hensley found out last year that she was pregnant again, she couldn鈥檛 bring herself to stop. She preferred Percocet and morphine.
鈥淚t was just one thing after another, you know, I was sick with morning sickness or sick from using. So it was either I was puking from morning sickness or I was puking from being high. That鈥檚 kind of how I was able to hide it for a while," Hensley says.
When the soon-to-be baby鈥檚 father Tyrell Shepherd discovered she was using, he was worried.
"If you don鈥檛 care about yourself, have enough common decency to care about the baby you鈥檙e carrying," Shepherd sayd. "Like, be an adult. Own up to what it is you鈥檙e doing and take care of business. Regardless of how bad you鈥檙e going to feel, there鈥檚 a baby that didn鈥檛 ask to be there."
But stopping opioid use is not simple. Doctors say quitting cold turkey is dangerous for the baby and sudden withdrawal in the mother could .
At nearly 6 months pregnant, Hensley was living on couches, estranged from her son, mother and Shepherd. That鈥檚 when she reached out for help. One moment, she dialed to get her fix. The next, she called hospitals and clinics.
鈥淣obody wants to touch a pregnant woman with an addiction issue," Hensley says.
And there鈥檚 a reason for that, says Dr. Jennifer Bailit at MetroHealth.
"These are difficult patients, they are complicated and they have complex social needs and many practitioners are just not equipped to deal with the depth and breadth of the kind of issues that they bring with them," Bailit says.
Research finds that addicted mothers often also struggle with other psychiatric diagnosis such as anxiety or depression.
After being rejected by two hospitals and several clinics, Hensley was advised by a receptionist at one of the local drug treatment clinics to go into withdrawal so she could get treatment. She did and then went to MetroHealth鈥檚 emergency department.
The hospital, operating a state-supported program, prescribed Subutex 鈥� an opioid therapy drug that keeps a low level of opioids in Hensley鈥檚 system but doesn鈥檛 bring on the highs that result in cravings.
MetroHealth treated Hensley鈥檚 dependency as a health condition, something physicians including Dr. Stephen Patrick at Vanderbilt University鈥檚 School Of Medicine in Tennessee support.
"I think it鈥檚 time for us to reshape how we view addiction in the United States. It is a medical condition it is not a moral failing," Patrick says.
When Valencia was born, mom and baby had their own room. Nurses encouraged snuggling and breastfeeding. And they were on hand to help Hensley if Valencia鈥檚 withdrawal became severe.
"She wouldn鈥檛 latch on, we couldn鈥檛 get her to feed, I couldn鈥檛 get her to stop crying, she was very fussy and I realized, you know, I did that to her," Hensley says fighting back tears. "I took her choice away. And that鈥檚 one thing I need to work through because I still haven鈥檛 forgiven myself for that. Not at all."
Babies in withdrawal have a distinct high-pitched scream and often their legs start shaking. It鈥檚 very difficult to comfort them. To help babies manage, medical staff typically darken the room and administer liquid morphine with a dropper into their mouths.
In the months after birth, Hensley and Valencia have moved in with Shepherd. Shepherd, who was fearful the baby would come out "messed up," has taken to being a dad.
"She came out underweight. She came out 6.1 for being a full term baby," Shepherd says, adding that now "Oh, she鈥檚 amazing, she鈥檚 great."
Through the MetroHealth program, a social worker checked in with the family for months. Hensley completed intense outpatient therapy and she continues to see a MetroHealth doctor once a month to check how her daily Subutex prescription is working.
They will adjust levels, if needed.
This story is part of ideastream's new multiple media project focused on 鈥淗ealthy Beginnings鈥� is one of many topics we鈥檙e covering in our Healthy People, Healthy Places series that explores the intersection of people, place, and health. You can access all the reports at .