Two Weeks

Two weeks til we have our first meeting to begin the homestudy. We'll meet at the agency office. We have to bring tax forms so we can establish the total we'll pay for the adoption (if it happens this year, anyway... it will change next year depending on changes in our income).

Tonight, we filled out 11 pages each for our SAFE questionnaires (structured analysis family evaluation). This is a standardized form used to write homestudies in our state and had almost identical questions to those we filled out for the state/DCS. If anyone is nerdy like me and interested in more information on this format, you can read it here.

To be honest, I feel pretty exhausted after filling it out. Delving back into hard times in the past, conflict with your spouse, etc. is not the most exciting way to spend your night. It does make me glad the rough times I've had are far and few between compared to many, though.

Romans 8

And the Holy Spirit helps us in our weakness. For example, we don’t know what God wants us to pray for. But the Holy Spirit prays for us with groanings that cannot be expressed in words. And the Father who knows all hearts knows what the Spirit is saying, for the Spirit pleads for us believers in harmony with God’s own will. And we know that God causes everything to work together for the good of those who love God and are called according to his purpose for them. For God knew his people in advance, and he chose them to become like his Son, so that his Son would be the firstborn among many brothers and sisters.- Romans 8:26-29 (emphasis added)

Approved

Our formal application was approved, so now the next step is beginning our homestudy. We'll have a joint meeting, individual meetings, and a home visit from our case worker. We'll supply much of the same documentation we did for our previous homestudy (financial documentation, medical physicals, etc). They'll instruct us on the online training we need to do, and I believe we'll need to read a book ("The Connected Child", which I had already bought back several months ago when we were still on the foster care path). Our case worker should call within a week to set up our joint meeting. Yay!

What I Happened Across This Morning...

Dear brothers and sisters, when troubles come your way, consider it an opportunity for great joy. For you know that when your faith is tested, your endurance has a chance to grow. So let it grow, for when your endurance is fully developed, you will be perfect and complete, needing nothing.

If you need wisdom, ask our generous God, and he will give it to you. He will not rebuke you for asking. But when you ask him, be sure that your faith is in God alone. Do not waver, for a person with divided loyalty is as unsettled as a wave of the sea that is blown and tossed by the wind. Such people should not expect to receive anything from the Lord. Their loyalty is divided between God and the world, and they are unstable in everything they do.

Whatever is good and perfect comes down to us from God our Father.

-James 1:2-8, 17a

Discouraged

Every time I look at our bank account, I feel so discouraged. It seems like time marches on, and our savings account is only slowly inching to where it needs to be. I'm such a planner, so it's difficult to not known an exact number we need to reach or an exact date we'll need the full amount by. It's just not my style to live with so much uncertainty.

I feel like it's all just not fair. I say, "Why us?" Why do we have to go through this process to be parents? Maybe I'm spoiled, but I work so hard, and planning nice trips is the main thing I look forward to. We've already forgone vacation last year and this year (a big deal for me). I have to be conscious to not fixate on it.

I realize trials can be refining. I guess this process is making us even more financially responsible, and it's teaching us (or me, at least) to be patient and learn to not stress once I've done everything that's within my control. It reminds me that I have been so blessed throughout my life since this is one of the more difficult struggles I've had when I know this is nothing compared to what others go through. It reminds me that God has always provided for me, whether it was through my family or by leading me to scholarships and jobs. It reminds me that when we have a child I won't ever be able to take them for granted.

Formal Application is In!

We finally finished filling out our formal application... and this is what popped up on our adoption portal. The formal application was all online (very handy) and included doing a bunch of math to add up bank accounts, look at assets and debts, etc... not fun for this right brained girl but thank goodness for a left brained husband!

Now, we will wait for our application to be (hopefully) approved, and we can proceed with the homestudy. It feels good to be moving along, but it's also overwhelming to think about how much money we still need to save!

Prenatal Alcohol and Drug Exposures in Adoption

This is a summary of a 2005 scholarly article examining multiple research reports regarding prenatal alcohol and drug exposure. It was really helpful to us in deciding what situations we are comfortable with, when the time comes.

“Families choosing to adopt domestically or internationally are faced with the possibility of prenatal substance exposure for their child. Alcohol use, drug use, and exposure to environmental agents by pregnant women can be harmful to the developing fetus, with many known short- and long-term effects on organ development, somatic growth, and neurodevelopment. As more families turn to medical providers for consultation before adoption, the challenge of accurately identifying risk factors for poor medical or cognitive outcomes becomes paramount.

Prenatal substance exposure is just one of the important factors in this risk assessment, but it is one that parents frequently have questions about before and after the adoption of their child”.

Alcohol

“Children born to women who drink heavily on a regular basis in the first trimester of pregnancy have the greatest risk of central nervous system damage. The first month of pregnancy is particularly crucial for development of the central nervous system and the midportion of the face. Unfortunately, this early in pregnancy, many women do not realize that they are pregnant and continue their usual pattern of alcohol ingestion”.

“Although there is no convincing evidence to date of a ‘‘safe’’ threshold of prenatal alcohol consumption, one major dysmorphology textbook argues that low birth weight and ‘‘mild’’ disability can be seen at an exposure of roughly 2 alcoholic drinks per day (lower in recent studies). When 4 to 6 drinks are consumed, additional clinical features become evident. Most of the children who are believed to have the full expression of Fetal Alcohol Syndrome are born to women consuming 8 to 10 drinks or more per drinking occasion, on a regular if not daily basis, for at least the first trimester. It is estimated that the risk of a ‘‘serious problem” in the offspring of chronically alcoholic women ranges from 30% to 50%. The greatest risk is that of mental deficiency as well as a host of learning and behavioral disabilities”.

“Manifestations of central nervous system dysfunction may include mental retardation or borderline IQ scores, neuromotor deficits, attentional issues and hyperactivity, and impaired social and adaptive abilities”.

Opiates

“There is no known congenital malformation associated with prenatal opiate exposure. There have been harmful fetal effects described with heroin and methadone use, however, and infants born to addicted women can suffer withdrawal in the newborn period”.

Effects on baby include low birth weight, increased risk of preterm delivery (less so with methadone compared to heroin), withdrawal symptoms (eg, hyperirritability, tremors, convulsions), gastrointestinal distress, respiratory distress, and autonomic disturbances (more severe with methadone because it has a longer half life).

“Recent studies… suggest mild memory and perceptual difficulties in older children [exposed to opiates], but overall test scores are still within the normal range”.

Tobacco

“Prenatal tobacco exposure has consistently been associated with poor fetal growth and is the single most important cause of low birth weight in developed countries. Even environmental smoke exposure has been implicated in low birth weight, fetal death, and preterm delivery. Finally, a growing body of evidence is implicating smoking during pregnancy in a range of adverse behavioral and cognitive outcomes”.

“Nicotine readily crosses the placenta and distributes freely to the central nervous system, having direct and indirect effects on neural development. Intrauterine hypoxia, mediated by carbon monoxide and reduced uterine blood flow, is a major mechanism of the growth impairment linked to prenatal tobacco exposure”.

“Tobacco smoking during pregnancy has been associated with placenta previa, placental abruption, premature rupture of membranes, preterm birth, intrauterine growth restriction, and sudden infant death syndrome (SIDS)”.

“Infants born to mothers who smoke tobacco display higher rates of impaired neurobehavior, with reduced habituation, lower arousal, hypertonicity and tremors, sucking difficulties, worse autonomic regulation, and altered cries”.

Marijuana

“Marijuana use during pregnancy may have a modest effect on prenatal growth, but the results are inconsistent from study to study…These effects, if any, are not associated with later growth deficiency, although a few studies have suggested an impact on height as well as persistent negative effects on head circumference in the offspring of heavy marijuana users. This review found no consistent link between prenatal marijuana exposure and other adverse pregnancy outcomes or congenital malformations”.

“Although prenatal tobacco exposure is associated with deficits in IQ, impulse control, and other fundamental aspects of performance, prenatal marijuana exposure does not impair IQ or basic visuoperception but influences the application of these skills in problem-solving situations requiring visual integration, analysis, and sustained attention. Marijuana is argued to have an impact on higher level executive function and performance in a ‘‘top-down’’ fashion, in contrast to tobacco’s ‘‘bottom-up’’ effects”.

Cocaine

“The use of cocaine in pregnancy has been associated with a number of obstetric complications, such as stillbirth, placental abruption, premature rupture of membranes, fetal distress, and preterm delivery”.

“Prenatal cocaine abuse may cause specific neurobehavioral and learning problems, although it is not associated with global cognitive deficits. Infant neurobehavioral abnormalities like irritability or excitability, sleep difficulties, and state regulation difficulty as well as transient neurologic abnormalities like tremor, hypertonia, and extensor posturing have been reported. Heavy prenatal cocaine use has been linked to poor memory and information processing in infancy. At 3 years of age, increased fussiness, difficult temperament, and behavior problems were described.” 

5/27/13- Current news article: http://chroniclesofanadoption.blogspot.com/2013/05/crack-baby-scare-overblown.html

Meth

“Although the impact of methamphetamine use during human pregnancy is currently unknown, animal studies have demonstrated neurotoxic effects of amphetamines and remodeling of synaptic morphology in response to prenatal methamphetamine exposure. One study did describe a smaller putamen, globus pallidus, and hippocampus in methamphetamine-exposed children”.

“Women using methamphetamine during pregnancy may have an increased rate of premature delivery and placental abruption. Methamphetamine use during pregnancy is linked to fetal growth restriction and, occasionally, withdrawal symptoms requiring pharmacologic intervention at birth. Clefting, cardiac anomalies, and fetal growth reduction have been described in infants exposed to amphetamines during pregnancy”.

“The scant research describing the outcomes of methamphetamine-exposed children describes possible links with aggressive behavior, peer problems, and hyperactivity. A small recent study found that methamphetamine-exposed children scored lower on measures of visual motor integration, attention,verbal memory, and long-term spatial memory. In rats, even low doses of prenatal methamphetamine exposure can alter learning and memory in adulthood”.

Other things to remember

“This review, and most of the research literature, has examined each of these alcohol and drug exposures one by one. In reality, polysubstance exposure is perhaps more common; however, to date, we have little understanding of how these and other prenatal exposures interact with each other to affect the developing fetus”.

“For children of adoption, it is sobering to consider how these substance exposures, in combination with other social and biologic risks, may make affected children more vulnerable to the adverse effects of malnutrition, neglect, abuse, multiple placements, or institutionalization. At a minimum, it seems less likely that early neurobehavioral problems can be repaired in such environments. Conversely, adopted children are typically received into loving and nurturing homes with motivated and resourceful parents. This is a remarkable intervention in and of itself, affording children with multiple vulnerabilities the opportunity for catch-up growth and development, formation of stable and secure attachments, early diagnosis of primary disabilities, appropriate services, and prevention of secondary disabilities. The lifelong impact of this caregiving trajectory on the long-term effects of prenatal alcohol and drug exposures remains to be seen”.

Source:Prenatal Alcohol and Drug Exposures in Adoption. From Pediatrics Clinics of North America. By Julian K. Davies, MD and Julia M. Bledsoe, MD.

Following a compilation of research regarding other substances not addressed in the above article:

Benzos

“There are many possible risks to the fetus whenever anxiolytic medications are prescribed to pregnant women. The onset of teratogenic effects may be immediate or delayed. Possible effects include abortion, malformation, intrauterine growth retardation, functional deficits, carcinogenesis, and mutagenesis. The risk of malformation is greatest when the fetus is exposed between two and eight weeks after conception. If the drugs are administered at or near term, they may cause fetal dependence and eventual withdrawal symptoms.”

Source: http://ps.psychiatryonline.org/article.aspx?articleID=86928

One study found benzo-exposed low birthweight babies caught up at “an early stage”. Gross motor development was behind from 6-10 months but was nearly normal at age 18 months.

Source: http://www.ncbi.nlm.nih.gov/pubmed/1351263

Babies exposed to benzos during pregnancy are at risk for low birthweight, breathing difficulties, floppy muscles, unstable body temperature, alteration in heart rate, and withdrawal syndrome (irritability, convulsions, etc).

Source: http://www.bcnc.org.uk/BZ_pregnancy.pdf

“Some early studies in animals and humans suggested a slight increase in the risk for cleft lip and/or cleft palate if a benzodiazepine was taken during the first trimester. Since these early reports, there have been studies and reviews that have not supported an association between benzodiazepines and cleft lip or palate or birth defects in general. It is generally felt that exposure to a benzodiazepine does not significantly increase the risk for birth defects”.

Source: http://www.mothertobaby.org/files/benzodiazepines.pdf

Antidepressants

“Tricyclic antidepressants (TCA) are generally considered safe for use during pregnancy (Gilstrap & Little, 1998, Lee et al., 2000). The birth incidence of congenital malformations is not increased nor does there seem to be any alteration of brain anatomy based on human studies. Considering cognitive and behavioural assessments there seem to be no negative effects of prenatal TCA administration.”

Example: amitriptyline

“SRIs are… prescribed and indicated for use in moderate to severe depression during pregnancy (Lee et al., 2000). Several studies have found no increased risk of congenital malformations when using SSRIs during the first trimester (Koren, 2001; Kulin et al., 1998; Nulman et al., 2002). With respect to cognitive development, Nulman et al. (2002)With respect to cognitive development, Nulman et al carried out a prospective controlled study using SSRI exposure throughout pregnancy. They found no increase in delay of cognitive or language development in pre-school or early school aged children. Similarly, Simon et al. (2002) found no increased risk of developmental delay or congenital malformations after SSRI exposure. However, a recent study by Casper et al. (2003) showed a different trend after SSRI exposure. In a well-controlled study, the children of depressed mothers exposed to SSRI or unexposed depressed mothers were followed up to age of 40 months. They found that children prenatally exposed to SSRIs scored lower on the psychomotor indexes of the Bayley Scales of Infant Development test and lower on the motor quality factor of the Bayley Behavioral Rating Scale. The authors suggest that subtle motor developmental delays may be one of the side effects of prenatal SSRI exposure.”

Example: Celexa, Lexapro, Prozac, Paxil, Zoloft

Source: http://www.oadd.org/publications/journal/issues/vol11no2/download/bercovici.pdf

Be Near

Local Adoption Scam

From NewsChannel5.com (click here to see the video of the story):

"They were hoping to become parents by adopting twins, but instead authorities believe a Hopkinsville couple fell victim to an adoption scam.  

The Christian County Commonwealth's Attorney said the couple did everything right for a private adoption, knowing one of their risks is that a birth mother can end up wanting to keep the child. However, authorities say in this case, the woman was never pregnant.

It's not a case Commonwealth's Attorney Lynn Pryor sees often. 

"I think this may be on of the more heartless, evil schemes," said Pryor. 

It's one that stands out after she said 22-year old Sara Pavey pretended to be pregnant with twin girls and made contact with a Christian County couple who wanted to adopt. 

"She went through great lengths to show she was going to doctors, even sending photos copied from google images," said Pryor. 

Pryor said Janet and Matt Wyatt took proper procedures for a private adoption, and in the end paid more than $10,000 to Pavey. 

"I don't want anyone to believe that they were foolish," said Pryor. "They weren't; they hired attorneys to do things properly."

Attorneys like Greg Smith who said unfortunately adoption scams are more common than you'd think. 

"A lot of people have adoptions that have been longing for it for so long, they're ripe for a con-artist to take advantage of," said Smith. 

It's why he recommends soon to be adoptive parents try to be as hands on as possible throughout the pregnancy.  

"Let them go to an ultrasound with them, not only do you get to see the baby moving, but if it's fraud, it's hard to hide it," said Smith. 

While the advice comes too late for the Wyatts, they're taking steps to keep this from happening to anyone else. 

"It breaks my heart that a family that wanted to have children so badly face the reality that they're not going to have two babies they so eagerly anticipated," said Pryor. 

At this time, it does not appear Pavey is in police custody yet. Her last known address is in Virginia. 

She has been indicted on a charge of theft by deception of more than $10,000 and a charge of persistent felony offender." 

Source: Janet Kim and News Channel 5 (Nashville)