I abused drugs during pregnancy and almost ruined my baby’s life

It is Friday morning when Lillian Wanjiru walks to Ngara Health Centre for medication.

Here, she is not judged and the methadone treatment she takes helps her with her addiction, much like the rest of the people who seek treatment at the facility.

Methadone treatment is a replacement therapy for patients with drug addiction.

On the other side of the clinic is the delivery centre where mothers deliver. Some of the newborns are treated for neonatal abstinence syndrome (Nas). This is a group of conditions that babies manifest when their mothers are on opioids.

Wanjiru, 30, started abusing drugs after she lost her child who had pneumonia at nine months. 

That same year, she joined her sister in Malindi, who was already abusing drugs. “I was so judgmental of her before I met a man who introduced me to heroin. I would administer it intravenously,” she says.

She says a syringe and needle were sold for as little as Sh10. She bought the heroin for Sh250.

Her desperation for drugs led her to prostitution to get money and she eventually graduated to using cocaine. 

“The more money I got, the more I smoked. I only stopped when a man who introduced me to heroin was killed by the police in a theft syndicate,” she adds.

Shocked at the revelation that her friend had been a thug for four years, she went back home to Nakuru. “There, I could not access the drugs. That forced me to clean up. I even gained weight,” says Wanjiru.

Just when she was at a high, doing better than ever, her fall beckoned again. This time, it was in the form of gambling. “This gambling gave me a lot of money. I used some to buy drugs, then ran away to Nairobi. I rented a lodging for a month, and things got worse from there. I did not know anyone, and that same month, while hanging around the place, a drug lord recruited me to sell heroin for his clients,” says Wanjiru.

Methadone treatment

A woman she met took her to Mathari, where they lived together before she finally met and moved in with the father of her second child. “I had tried conceiving several times but could not. Stressed up, I turned to drugs. My boyfriend was then receiving methadone treatment at Mathari, and he insisted that I do the same. Three months after being on methadone treatment, I conceived. I cried with joy,” says the mother.

Wanjiru says her pregnancy was uneventful and she gave birth to a daughter, weighing 3.8kg. And even though medical records confirm that her baby did not immediately suffer from Nas, she at one time exhibited the symptoms due to methadone withdrawal.

Nas is a group of conditions that a baby exposed to opioids in the womb manifests before birth. It is occurs when a woman takes drugs during pregnancy.

 “I had gone home for about three weeks and that meant I could not get methadone. My baby was still breastfeeding, and my body stopped producing milk. Lack of it also made me weak, and I could not even cook food for her,” she says shaking her head.

Caroline Nyambura’s daughter refused to breastfeed immediately after birth. This, according to Jackline Kisilu, a nursing officer at the centre, is one of the symptoms associated with Nas.

However, her daughter’s symptoms manifested due to methadone withdrawal.

While Nyambura, 24, was in labour, she could not take methadone since that means walking to the methadone administration point. When she finally delivered and the nurses delivered her daily methadone dose, she began to feed, getting methadone through the breast milk.

Nyambura’s daughter is now two-and-a-half months old and was conceived while on methadone treatment.

She considers herself lucky because she gave birth to her second-born while on active drug use. When she was jailed at Lang’ata women’s prison for theft in 2017, she checked in with her baby.

“Nothing changed when I was jailed. The police officers supplied the drugs, and we smoked them at night so that we would behave normally during the day. The only challenge was that I could not breastfeed the baby if I had not smoked,” she says.

Her first encounter with drugs was in Mombasa, where she had gone to work for her aunt as a domestic manager. She has only taken cocaine once, she says.

Delayed milestones

Kisilu, the nursing officer, explains that children who exhibit drug withdrawal symptoms may in the long term have slow learning ability, malnourishment, low weight and delayed milestones.

She says the diagnosis of Nas depends entirely upon getting a good opioid history of the mother. Once the medic knows the history, they know the symptoms to look out for.

“When an expectant mother on opioid use comes to our centre, we take a very detailed history of her use. This includes a mention of the drugs she was using, for how long, whether she started before or after conception,” says Kisilu.

Nas can also be exhibited by children whose mothers are not drug addicts but are using antidepressants, due to injuries or surgery while pregnant, she tells HealthyNation. “When this happens, the mother is put in an opioid treatment and the child can get Nas due to the effect of that drug,” she adds.

A baby who scores eight and above can show symptoms immediately after birth. These include diarrhoea, inability to suckle, failure to cry after birth, high-pitched screams, muscle twitch and convulsions. The symptoms can extend from six months to a year.

“Once the baby exhibits the symptoms, you give methadone, and they improve. As they get better, they get weaned off the methadone, until they have completely recovered,” says Kisilu.

For adults beginning methadone treatment, the patient is introduced to a small amount as they simultaneously reduce the number of drugs they are taking. Progressively, the methadone levels are increased as the drug levels reduce until they are eventually weaned off.

Heart rate difficulty

“It is important to know that Nas is only exhibited by mothers who have not been on methadone treatment. However, if the mother is on methadone, it is rare for their children to get Nas. But some mothers use methadone and do drugs at the same time, and the babies eventually get Nas due to overdose, since the drugs and methadone are in the same class,” she says.

“The only downside to methadone is withdrawal symptoms, which manifest when it is not administered in correct proportions.

The symptoms include sweating, increased heart rate difficulty in breathing, joint pain, diarrhoea and vomiting. We call it cold turkey,” explains the nursing officer.

Other complications include convulsions, which, as Kisilu states, are not normal. She notes when a child convulses they have less oxygen in the brain.

“The child can in the long term be mentally retarded due to convulsions or die,” she adds.