By Emily Todd, MD
1) Ask about alcohol use. Ask specifics about how much alcohol was consumed and when it was consumed during the pregnancy. The Institute of Medicine says, “Of all the substances of abuse (including cocaine, heroin, and marijuana), alcohol produces by far the most serious neurobehavioral effects in the fetus.” There are still a lot of unanswered questions about alcohol and the developing fetus that medical researchers are working hard to answer. However, in general we know that alcohol can have a negative effect on the fetus at any time during the pregnancy and that the more alcohol that is consumed, the greater the risk of more serious birth defects, neurological issues and behavioral issues in the child. These challenges to the child are permanent and will last a lifetime.
2) Ask about illicit drugs. Although the outcomes of children prenatally exposed to illicit drugs has not turned out to be as severe as we initially thought, children prenatally exposed to drugs such as cocaine, heroin, and amphetamines are still at risk for neonatal abstinence syndrome as well as attentional issues, behavioral outbursts and other problems of executive functioning.
3) Ask about smoking. Although it is both legal and common in use, smoking tobacco Adoptionwhile pregnant causes serious problems to the developing fetus. We know that prenatal exposure to tobacco cigarettes causes low-birth weight babies, an increased risk for sudden infant death syndrome (SIDS), asthma, increased respiratory infections and attention deficit hyperactivity disorder (ADHD). Now that states like Colorado and Washington have legalized smoking marijuana we see much more smoking of marijuana during pregnancy, too. Although there are limited studies on what effects marijuana cigarettes may have on the developing fetus, initial reports suggest that issues may be similar to that of tobacco cigarettes.
4) Ask about prescription medications used. Some prescriptions, while they are important to keep the birth mother healthy, can be dangerous to the developing fetus. There are resources, including pregnancy registries, that can provide more information on what the potential harms may be.
5) Ask about medical problems in either herself or the birth father. Don’t forget that 50% of the child’s genes come from the birth father. You will want to know details about his health history as well as that of the birth mom.
6) Ask about history of surgery. Conditions like cleft palate may not be an issue for the birth mother (or birth father) now, but they often have a genetic link and may be passed on to the child.
7) Ask about medical conditions that run in the family. Even though it may not be a deal breaker, it is important to know about chronic medical conditions that may run in the biological families. Conditions like type II diabetes and high blood pressure have a strong family link. It will be important for the child to learn to make healthy lifestyle choices to minimize the risk for development of these common conditions.
8) Ask specifically about mental illness. People often don’t think to mention mental illness when telling you about family health conditions. We know from extensive medical research that the development of mental illness is a combination of heredity and environment. This means that although as an adoptive family you are providing the child with a loving, nurturing home, the child may still have a genetic risk to develop ADHD, anxiety disorders or even schizophrenia.
9) Ask about education. How far someone goes in school can give you a clue into their intellectual development. This may help you in how you speak to, or interact with, the birth mother. It may also be helpful in setting expectations for your child.
10) Ask your birth mother to keep you updated on any new medical conditions that are diagnosed in herself, the birth father or the extended biological families. If you have an open or semi-open adoption, this should be something you revisit with the birth mom every year or two. Many common medical conditions, including Alzheimer’s disease and coronary artery disease, develop later in life but it remains important for a child to know those conditions run in their family.
Dr. Emily Todd is an Adoption Medicine physician. She founded Comprehensive Adoption Medicine Consultants to help families navigate the medical side of the adoption process. In her practice, Dr. Todd helps adoptive families in all phases of the adoption journey: from pre-adoption consultation, to comprehensive file review, to assistance with identifying resources for the ongoing care of the adopted child. In addition to her office job, Dr. Todd loves to donate her time to speaking with adoption medicine support groups about various medical issues. She also serves on the Colorado State Board of Directors for Gift Of Adoption Fund. Dr. Todd counts herself fortunate to live in Colorful Colorado with her husband and two beautiful children.
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