Learning from W.Va. neonatal drug rules

According to a recent Post-Gazette investigation, roughly 1 in 10 babies born to mothers from the rural southwest corner of Pennsylvania is exposed to drugs during gestation. It’s a shocking statistic that shows how despair is being passed down through the generations, literally in the blood that is shared between mother and child.

But we could only know this because most moms from Greene and Fayette counties give birth in Morgantown, W.Va. (The last obstetrics unit in those counties, at Uniontown Hospital, was shuttered in 2019.) Pennsylvania hospitals don’t test for, and the Department of Health doesn’t track, neonatal drug exposure — but West Virginia does.

Harrisburg should follow Charleston’s lead here. Pennsylvania’s hospitals and public health authorities should have the best and most accurate information possible to track, to understand and ultimately to tackle the maternal drug crisis.

The situation in Pennsylvania with regard to testing and tracking neonatal drug exposure is embarrassing: If it weren’t for cross-border births, we’d be almost completely in the dark. In fact, we know more about the health of rural Pennsylvania babies from West Virginia databases than we do from the commonwealth’s.

For instance, it is only from data collected in Morgantown that we can identify a 60% increase in the rate of neonatal drug exposure in Greene and Fayette counties from 2017 to 2021. Meanwhile, according to Pennsylvania’s incomplete and obsolete data — the most recent numbers come from 2019 — maternal drug abuse in the rural southwest is actually decreasing. We can’t address a problem we can’t see, and Harrisburg is blind as a bat.

The main difference is this: Morgantown’s Ruby Memorial Hospital, following state guidelines, tests the umbilical cord tissue of every mother for eight potentially harmful substances, from alcohol to opioids and methamphetamines.

But Pennsylvania hospitals, following this state’s requirements, only look for the (often subjective and ambiguous) signs of acute opioid withdrawal in newborns — high-pitched crying, poor feeding, trembling and so on.

Further, while West Virginia’s testing is completed and reported within a day or two, Pennsylvania’s neonatal opioid withdrawal data takes weeks or months to percolate through the system.

The phrase “deaths of despair” describes the recent rise in deaths from suicide and addiction that led, for the first time in a century, to a multiyear decline in American life expectancy. As with its sibling hate, despair emerges from a void of meaning, from the feeling that one’s life not only is not valuable now but also has no foreseeable chance of becoming valuable — to society, to some higher power, to oneself.

How much more, then, does drug abuse during pregnancy speak to despair? It says that not only is one’s own life worthless but, in poisoning one’s child, that the next generation’s lives will be worthless, too.

It passes down despair psychologically and physiologically. It’s a symptom of a profound social illness that, left unchecked, will affect more and more people.

For the sake of public health and the public good more generally, it’s time for Pennsylvania to catch up with our neighbor to the south and west: Test and track neonatal drug exposure like West Virginia does.