Deep down, first-time parent Brian Higgins had to admit, he was hoping for a boy. Visions of shared Phillies victories danced in his head, as well as pint-sized St. Joe's jerseys and having a buddy for Eagles games.
But during an ultrasound appointment in the spring of 2016, the Newtown father-to-be and wife Jodi wanted nothing more than a verdict of good health. Suddenly, a fetal image appeared on the monitor screen. Sounds of a strong heartbeat filled the room.
Brian started to cry. Jodi teared up, too. Ears, eyes, a nose – the technician ticked off the good news. And then something else.
"It looks like you're going to get your boy, Brian!" the mother quipped, grinning.
But that wasn't Jodi speaking.
Rather, it was the birth mother of that baby boy, a child the Higginses would name Patrick.
The Philadelphia woman was under medical care, managing her opioid addiction during her pregnancy with methadone, because sudden withdrawal can endanger a developing fetus. But she was taking one more step to protect the child. She was allowing her baby to be adopted by a family that could offer him the kind of life and stability that she could not.
Theirs is a little-told but increasingly common story in an opioid epidemic that continues in the Philadelphia region and many other parts of the country.
"It's true nationally, not just in Philadelphia, that of the children being placed for private adoptions, more of them had previously experienced substance exposure, including exposure to opioids, or were born with an addiction to opioids," said Ryan Hanlon, vice president of the National Council for Adoptions.
Adoptions From the Heart, a locally based, private adoption agency, saw its rate of opioid-involved birth mothers rise from 33 percent in 2016 to 52 percent in 2017. Likewise, the Open Arms Adoption Network, a program of the Jewish Children and Family Services of Greater Philadelphia, reported a 50 percent increase in babies exposed to opioids in the womb.
Through these adoptions, children are placed in secure homes with loving parents, many of whom have tried to adopt for years. Adoptions in the United States have declined in recent years, largely because unmarried parents do not face the stigma of years past, and because international adoptions have plummeted due to government restrictions.
'A better life'
Across the country, drug use is driving up the number of children being removed from dangerous situations and placed in foster care. Meanwhile, some women, such as Patrick's birth mother, choose adoption so they never expose their child even to potential risk.
A Baby Step Adoption, the Pennsylvania agency that helped Brian and Jodi Higgins, conducts outreach programs to let prospective birth mothers know their choices. Director Barbara Casey said her agency is planning an information session soon at Prevention Point, a needle exchange and support organization in Kensington, the epicenter of Philadelphia's opioid epidemic.
"Every single birth mother I've ever worked with loves their child," said Danielle Goodman, a supervisor with Adoptions From the Heart.
For Candy Barone, 30, the decision to put her child up for adoption was "the hardest thing I have ever had to do in my life," she said.
The Delaware woman's daughter Presley, now 2, was adopted by a Pennsylvania couple. "I did it because I loved her so much that I wanted her to have a better life than I could give her," Barone said.
At the time, she and her husband were both using heroin.
"I did care, but it wasn't me. It was like the drugs took over, and at that point, it wasn't a choice anymore. It was a need," said Barone, who was 38 days clean when interviewed earlier this May and working as a veterinary technician.
Her daughter's adoptive parents have a nice house and three dogs that Presley loves. Soon, the two families will have their second annual visit.
Most agencies allow varying degrees of open adoptions. Some birth mothers, despite good intentions, let their contact lapse. Others die of overdoses. But many receive regular updates on their children or even schedule visits.
"Seeing her, I know I made the right choice," said Barone, who has three other children. "She's beautiful. She's happy."
For the adoptive parents of babies born with an opioid dependency, the first few weeks are agonizing. Most of the babies require an extended stay in neonatal intensive care as they tremble and cry their way through opioid withdrawal.
Then come the months and years of wondering what effects opioids will have on their babies.
The research is inconsistent, but some experts say the signs are promising.
At a recent information session by Open Arms Adoption Network, Dennis Hand, an assistant professor of obstetrics and gynecology at Thomas Jefferson University, told a roomful of prospective adoptive parents about a study that found no developmental difference between opioid-exposed and unexposed children up to age 3. But the children in the study, like Patrick, were exposed to methadone and buprenorphine, which are prescribed for medication-assisted therapy. Their mothers were not using heroin or illicit prescription drugs.
Erin Meyer, a pediatrician and internist at Christiana Hospital in Delaware, holds information sessions for families who work with Adoptions From the Heart. From her professional experience with babies exposed to opioids, Meyer has found that some may need extra help with school, or experience increased anxiety. But, she said, most seem to catch up developmentally to other children by kindergarten age or long before.
Meyer and her wife, Sandra Medinilla, a trauma surgeon at Christiana, adopted three children, now ages 21 months, 7 months and 6 weeks. Two were exposed in utero to opioids; the other to opioids and cocaine.
"It's busy at our house, but we are blessed, and we're having a blast with our kids," Meyer said. "Our oldest is putting two and three words together. He's smart."
So is Teagan Jameson Paul. At 17 months, she walks, talks and wields a fork. She loves music and monkeys. She's headstrong and bold, which delights her mother, Robin Paul, a legal data analyst from Mount Laurel who adopted Teagan through A Baby Step.
But Teagan also has challenges. She is small compared with other children her age, and has asthma and chronic earaches.
"When you have a child who's been exposed 1/8to opioids3/8, it's the first thing your mind goes to: Is this because she was exposed?" said Paul, 44.
Paul, a single mom, at first was leery about adopting a child with opioid exposure. Now she's grateful she changed her mind.
"I think if I hadn't been open to it," Paul said, "what I would have missed – having this amazing human in my life."
When Teagan is older, Paul plans to tell her about her biological family's drug use.
"I think it's important for her to know that," Paul said. "I don't think some of the things other kids will do or want to try are in her best interest, given her history. That's something I will be discussing with her throughout her life."
'A real gift'
Patrick Higgins, now 21 months old, is a sports fan in the making. He wore an Eagles T-shirt during the Super Bowl, even though most of the game was past his bedtime.
Born two months early, Patrick gets support through Early Intervention, a state-funded program that provides services to young children at risk for learning or developmental delays. Jodi, 52, said they monitor Patrick's milestones more carefully than they would another child. His birth mother has sent messages, asking about him, too.
"As soon as I touched him, I was in love," said Jodi, who has two grown biological children from an earlier marriage.
For Brian, 54, a financial analyst, parenthood is a new experience. Already, it is hard to imagine life without his boy.
"Even if I had a boy who looked like me and sounded like me and had all my features and idiosyncrasies, I don't think I'd love him any more," he said. "He's been a real gift."