This episode of West Virginia Public Broadcasting’s podcast Inside Appalachia was produced in collaboration with 100 Days in Appalachia and the Ohio Valley ReSource as part of the collaborative reporting project Born Exposed. Read the full series here.

This article was originally published by West Virginia Public Broadcasting.

This week on Inside Appalachia, we’re dedicating our episode to all the children who are affected by substance abuse before they’re even born. Neonatal Abstinence Syndrome (NAS) is a topic that is heartbreaking, but critically important for us to spend some time understanding. The stigma that follows mothers, and their unborn babies, is keeping them from getting the prenatal care, and help for recovery, that women across our region desperately need. 

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But there are stories of hope and resilience among those grappling with the fallout from the opioid epidemic. Not all children who are born exposed to drugs show signs of NAS. And researchers still don’t know what the long term impacts will be, if any. Each case is unique. What we do know is that forming loving relationships with caretakers helps children be more resilient. “All children benefit from stable, safe, and nurturing relationships and environments,” according to a 2017 report by Child Trends. “However, these relationships and environments are particularly important for young children who have experienced trauma. Their presence and stability can help children recover from past trauma and develop the skills to cope and thrive,” the report said. 

In This Episode:

The number of babies across the country who suffer from NAS has increased in the past several years, according to national and state health officials. Those reports indicate that the numbers are among the highest in central Appalachia. Five out of every 100 babies born in West Virginia have NAS — that’s up from three percent in 2013. In 2016, there were over 1,200 babies born with NAS in Kentucky. That’s more than 100 cases each month. 

Some Women Say Doctors Turned Away

Cayden’s mother Callie Relford, 29, struggled with addiction for years before her daughter was born. Photo: Joanie Tobin/100 Days in Appalachia

The stigma associated with addiction often makes it difficult for pregnant women struggling with substance use disorder to get the prenatal care they need. Producer Jess Mador reports on one East Tennessee clinic that’s pushing for changes in drug treatment for pregnant women, in hopes of keeping more babies from coming into the world with NAS.

“They don’t trust anybody,” Emily Katz said. Katz is a substance abuse coordinator with High Risk Obstetrical Consultants in Knoxville, Tennessee. “They’re embarrassed, and so many times we have heard from them, ‘you’re the first person that would listen’ or ‘you’re the first person that I’ve told this to.’”

Doctor’s Don’t Agree On Best Practices

And we hear from doctors and medical experts across central Appalachia, as they discuss the protocols to best treat for the best way to care for these moms-to-be and their babies. But as Kara Lofton reports, “standards” can still vary from state to state, facility to facility. 

Foster Care And Education 

Despite so many obstacles, like trauma, and the physical impacts of being born exposed to drugs, children can be resilient. But helping them means getting them into a stable, loving home. How does the opioid epidemic affect the foster care system? And how are teachers impacted by families touched by addiction? Those stories and more in this episode of Inside Appalachia.  

Adaline plays with her great-grandfather before attending her dedication ceremony. Church is a source of strength for the Robbins family. Photo: Joanie Tobin/100 Days in Appalachia

West Virginia Public Broadcasting’s Glynis Board guest hosts this episode.  She closes the show with these personal remarks:

“Data have revealed there is a window of opportunity where women seem to be able to access incredible strength and motivation to overcome their battle with substance use disorder. Strange as it sounds — within the struggle these women face lives a kind of hope for our entire region, that we can help each other and be inspired by each other to overcome this crisis. Maybe we can even discover, and begin to deal with, some of the root causes of addiction that so many of our friends, neighbors, sisters and mothers face. Maybe. We like to dream big here Inside Appalachia.” — Assistant News Director Glynis Board, West Virginia Public Broadcasting.

Born Exposed is a project of 100 Days in Appalachia, West Virginia Public Broadcasting and the Ohio Valley ReSource. The OVR is supported by the Corporation for Public Broadcasting and West Virginia Public Broadcasting. This episode also included stories from StoryCorps and Side Effects Public Media. 

Roxy Todd is the producer. of Inside Appalachia, Eric Douglas is the associate producer with executive producer  Jesse Wright. He also edited the show this week. The audio mixer is Patrick Stephens.

You can find the show on Twitter @InAppalachia.

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This article was originally published by 100 Days in Appalachia, a nonprofit, collaborative newsroom telling the complex stories of the region that deserve to be heard. Sign up for their weekly newsletter here.