The number of expecting mothers who abuse drugs is on the rise. Research shows about 10 percent of pregnant women suffer from drug addiction.
“This is a diagnosis that is pretty much higher than any other infection we screen for in moms,” said Dr. Tony GiaQuinta, a Pediatrician at Parkview Health. “It’s higher than Syphilis and HIV.”
As a result, hospitals in Northeast Indiana are turning to the baby’s umbilical cord to test newborns for exposure to drugs. They believe it is a more effective way to test for exposure to drugs in the womb and get mothers and babies help if they need it.
“With the umbilical cord we know it’s going to be there for every baby every time at the delivery,” said Dr. James Cameron, a Neonatologist at Lutheran Health Network.
For decades doctors have used a newborn’s feces, hair follicles, and finger nail clippings to test for drugs.Those results could take two to three weeks to come back and doctors have found these methods are not as effective as the umbilical cord.
The umbilical cord carries nutrients from the mother to the growing baby. A piece of that cord can detect drug use through the last trimester of pregnancy. The results come back in one or two days which allows doctors to identify at-risk babies faster.
“You know we’re seeing an increase in the number of people overdosing on opiates and testing positive for opiates,” said Cameron. “But we’re not really seeing an increase in the number of babies testing positive for opiates.”
Cameron took his concerns to Allen County Health Commissioner Dr. Deb. McMahan.
“We had no protocol,” she said. “Dr. Cameron came to me and said he was just concerned that there were babies being missed.”
This practice is relatively new to Fort Wayne, but hospitals across the country have been using umbilical cords to test for drug exposure over the last several years.
McMahan said statistics show that anywhere from 10 to 30 percent of babies are born to mothers who abuse prescriptions or use street drugs.
This 15 Finds Out investigation began with a tip to our hotline in July. A mother was concerned because her newborn son’s umbilical cord was tested for drugs without her permission.
Ciara Beckler said she learned from a caseworker with Indiana Department of Child Services that the test came back positive for marijuana hours have she had given birth.
“She told me that they test the baby’s umbilical cords now and I had marijuana in my system and that is why she was in my room,” said Beckler.
Policies can vary depending on the hospital, however 15 Finds Out has learned that Lutheran and Parkview do not require a mother’s consent to test a newborn for drugs. Beckler would not say what prompted the doctors to send her baby’s umbilical cord for testing. Doctors test babies who exhibit withdrawal symptoms or mothers with a history of drug abuse.
“We treat this testing like any other medical condition,” said GiaQuinta. “So if the baby was at risk for infection we would want to test the baby for bacteria in their blood get chest x-rays or other lab values.”
Hospitals are required by law to report any positive results for illegal drug use to DCS. Doctors said the ultimate goal is to keep moms and babies together. Separation is a last resort.
“The Department of Child Services certainly has a stigma that they are there to separate moms and babies and that is just not true, ” said GiaQuinta.
“It’s not in a baby’s best interest to take the baby away from the mother,” said McMahan. “So that’s not the primary strategy. But each case of course would need to be assessed but the goal is really to keep the mother and baby together.”
In Beckler’s case, she admitted to smoking pot while pregnant but adamantly denied using any other drugs. She agreed to take an additional drug screening provided by a DCS worker.
“It showed up as cocaine something I’ve never done before,” said Beckler.
Because of health information privacy laws, we cannot confirm what drugs she may have tested positive for.
Beckler said as a result of at least two positive drug screens, DCS placed her newborn and two other children in a home with other family members temporarily. She believes a mother’s permission should be required to test the baby’s umbilical cord.
“I’ve already had post partum depression and being separated from my newborn baby that I’ve only got to spend two weeks with is very hard on me,” she said.
Through umbilical cord drug testing doctors have learned that marijuana is the most common drug used among pregnant women across the state of Indiana.
According to a report from the Indiana State Department of Health, a total of 4,770 cords were tested between Jan. 1, 2017 and May 31 2018 across the state. Roughly 19 percent of those results came back positive for marijuana, compared to 21.4 percent nationwide.
Despite a growing push to legalize marijuana across the country the jury is still out on the effects it has on the human body. Especially, for expectant mothers. Doctors caution against using the drug during pregnancy or otherwise.
“There’s been a trend or thinking that marijuana is safe for these pregnant moms and it won’t affect their babies,” said GiaQuinta. “We are finding that is not the case.
“Think of all the complex genetic growth that this baby is undergoing at a time when you are putting toxin in,” said McMahan. “It just doesn’t make any sense.”
However, Dr. Jeannie DiClementi, who is a licensed clinical psychologist, points out that there may not be enough research and evidence to determine whether potential benefits outweigh the negative aspects.
“It’s all been personal stories or anecdotes,” said DiClementi. “But I will tell you doctors have been secretly recommending people try pot for decades. It’s far widely more accepted than anybody realized. It was just undercover… it was just hidden.”
Although, DiClementi does not recommend that expecting mothers use marijuana, she said it comes as no surprise to that it is the most frequently used drug among pregnant women. She cautions that the statistics could be deceiving, though.
“Keep in mind some drug tests don’t pick up on a lot of the other drugs,” she sasid. “Because the drugs burn out of the system or metabolize out of the system very quickly.”
Beckler said she has since regained custody of her children.
Umbilical cord testing has been discussed on a state level over the last few years. Lutheran Health Network began the testing two years ago and Parkview over the last year.
“In Northeast Indiana we have developed the first ever screening pathway for these moms and babies once they come in at risk for substance use disorder so that every baby is screened appropriately and consistently,” said GiaQuinta. “Everyone is also plugged into a developmental follow up pathway.”
Cameron said Lutheran keeps a piece of every baby’s cord for 5 to 7 days.
“We want to have a specimen available for every baby at this point,” he said. “So that if the baby goes home after it is discharged and the pediatrician suspects there might be some concern for withdrawal symptoms they can call back to the hospital and say, ‘you know we have some concerns the baby is withdrawing can you send that cord for testing?'”
The tests can cost about $180 and are typically covered by health insurance. Doctors said it has helped identify a greater number of mothers and babies in need of treatment.
“It really does the best testing I think of any kind of testing because it just does it all,” said McMahan.