The sound of a heartbeat pulsates through the air, and a grainy image of a baby flashes on screen. Jessica Hill smiles from her chair in the ultrasound room.
Gathered around are her doctor, nurse and best friend.
They are all eager, anxious, excited — and worried about the health of the baby. In that way, this ultrasound is like most.
But what’s happening in this room is anything but routine: Jessica, 28, is hooked on opioids and detoxing during pregnancy. Dr. Craig Towers is the pioneering — and controversial — obstetrician shattering the common medical belief that this approach could lead to the death of the fetus.
Moments earlier, Jessica’s baby underwent a stress test to see how she was progressing, a way to make sure the stress of detoxing is not harming the child. “She didn’t like it at all,” says Jessica, who is in her 35th week of pregnancy.
“It means that she’s paying attention to what’s going on,” says Towers, who specializes in high-risk pregnancies at the University of Tennessee Medical Center.
Jessica admits to making many mistakes, but here, she is making what she says is the best choice of her life: getting clean for her baby. She also has an 8-year-old son who has been raised by her mom. She hopes detoxing will further heal their relationship.
A tattoo above her heart reads “From pain comes strength.”
She wishes she could lean over her belly, put her lips by her daughter’s head and whisper to her about life lessons. “I’m working on building our relationship and trying so hard. I mainly want her to know that I won’t make those choices any more.”
Jessica marvels at the screen. “Is that her little face?”
“Yeah, that’s a cheek,” Towers says.
“She’s got chubby cheeks,” Jessica replies.
When Jessica first came to Towers four months ago, she was taking a standard opioid-based maintenance medication, called Subutex, meant to keep her from getting her fix from the street. She had been told at a drug maintenance clinic that detoxing would kill her fetus.
When she went to a doctor who she hoped could deliver her child, Jessica was humiliated. She had informed the doctor she was taking Subutex to tamp down her urge for painkillers. The doctor, she says, told her they don’t “take irresponsible patients.”
“I was just so upset, because they just shunned us away,” she says.
The maintenance clinic then referred her to the University of Tennessee Medical Center. Jessica first visited a doctor at the hospital’s prenatal clinic in December and was introduced to Emily Katz, the substance abuse coordinator in Towers’ office. Katz saw a young woman who needed help — but, more important, wanted help.
“We snatched her up,” she says. “There was just a spark in her. When I told Jessica, ‘I think we can help you,’ tears just streamed down her face.”
It’s now mid-March. Towers has weaned Jessica off the medication slowly, with Jessica making the hour-long trip from her home in Morristown to his office every two weeks, almost always accompanied by her best friend, Stephanie Moore. Today, Stephanie chimes in with cheerful jokes about the baby’s stubbornness, similar to her mother’s.
In between visits, Jessica texts and phones Katz, who was motivated to help others after her brother died of an overdose. The two have become so close over the months that both say they’re like twins separated at birth. Jessica has nicknamed Katz “Nurse Barbie” for her attractiveness and her straight blonde hair.
On this day, Katz quietly observes during the ultrasound, making her show of support by just being there.
Jessica went completely off the opioids over the past week, a critical juncture during any detoxification. She suffered through diarrhea and other ailments. Only once did she give into her urge, taking one Subutex pill. “It sucks,” she says.
In those down moments, Stephanie and Katz remind her why she’s going through this: that the struggle is worth the pain.
But even with all that Jessica has endured, there’s no guarantee her baby will be free of the violent tremors and excruciating pain that marks those born to addicted mothers. About one in five women who detox in Towers’ program still sees her baby suffer withdrawal after birth, depending on how early in pregnancy the mothers were able to become drug-free and how their bodies metabolize the opioids still in their systems.