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EVERETT - On a crisp February evening, Edna Pinon-Garcia felt her first contraction.
She was in early labor. She grabbed the keys to her brother's '95 Honda Civic and her grocery money - $25 in cash.
It was just enough cash to get a quick fix of heroin and just enough heroin to have the energy to assemble baby Daniel’s crib.
Even though she knew she shouldn't risk using the drug.
"I knew all these devastating things were going to happen to my first child - my one and only son," she said. "But I couldn't stop."
When Daniel Fabela-Pinon was born at a Tacoma hospital just hours after his mom got high, he joined a heartbreaking group: the tiniest victims of an opiate epidemic gripping Washington state and the rest of the nation.
"People tend to imagine pregnancy with this kind of perfect purity, as though it's unaffected by other problems in life. But of course, that's not true," said Dr. Jim Walsh, medical director of the addiction recovery program at Swedish Hospital.
Doctors told 24-year-old Pinon-Garcia that her baby tested positive for opiates. He was going to need special care.
But she already knew that.
She knew it the moment she heard his high-pitched, abnormal cry; when she saw Daniel's lips quiver and the rest of his body shake; when she heard his sneezes and saw his diarrhea.
After all, the first-time mom had lived through those same withdrawal symptoms before. She'd been chasing heroin's high for more than two years.
"I was powerless to do anything about it," she said. "It was emotionally devastating to see my child go through that."
The number of babies born with neonatal abstinence syndrome - a drug withdrawal diagnosis - has soared in Washington state, according to hospital data analyzed in a recent Office of Financial Management report and a Centers for Disease Control report released in August. Everett, Tacoma and the Olympic Peninsula are among the hardest hit areas in the state, the Washington report found.
While the image of Daniel and other newborns withdrawing from a drug like heroin is jarring, experts said that's not the biggest issue facing these children and their addicted moms.
If medical providers manage a baby's opiate withdrawal symptoms, the child can leave the hospital healthy in a matter of weeks. Today, Daniel is a happy and healthy 7-month-old boy.
Experts said the danger comes when a newborn's withdrawal symptoms go untreated. That happens when hospitals are not equipped to recognize signs of opiate addiction, and when addicted soon-to-be mothers are too afraid to seek treatment and prenatal care during their pregnancy.
"There's this idea that you are not a good mother or you don't love your child because of your addiction problem. That perception is really unfortunate because it tends to drive people away from seeking help," Walsh said.
What happens after the mother and child leave the hospital is also a concern for addiction experts and child safety advocates. Social workers face a balance of keeping families intact when a mother is willing to get help, or removing children from addicted mothers who are not fit to parent.
"The combination of a parent who is potentially using substances and a high-risk newborn who is having withdrawal symptoms makes it a pretty dangerous situation if there's not some sort of intervention," said Jenna Kiser, intake and safety program manager at Washington's Children Administration.
Without that intervention, researchers worry the child will suffer long-term consequences- worse than the short-term health impacts after birth.
"Growing up with an opiate-addicted parent has long-term resonating effects for most young people that are really profound - including mental health problems, substance abuse problems, criminal involvement problems and school failure," said Kevin Haggerty, director of the Social Development Research Group at the University of Washington.
WHEELING DANIEL AWAY
For Pinon-Garcia, the only thing harder than seeing her son's withdrawal from heroin was watching a Child's Protective Services worker wheel Daniel away in an incubator.
WATCH: 'It was like getting a piece of me taken away' (:23)
In one room, doctors worked to help her son withdraw from heroin. Down the hall, Pinon-Garcia snuck inside the hospital bathroom to use again.
"I couldn't stop. It's like you sell your soul to heroin," she said.
Pinon-Garcia said she asked for help when she first saw those two pink lines on her pregnancy test. Doctors told her the baby could die if she quit using heroin without medical assistance. While pregnant, she enrolled in methadone treatment at Swedish Hospital - a common solution for pregnant addicts to overcome their addiction before their babies are born.
But heroin's grip was too tight. The drug is so powerful that 132 people overdosed and died last year in King County alone, according to a heroin task force report.
Pinon-Garcia relapsed. Her life spiraled so out of control that she was embarrassed and afraid to see a doctor for prenatal care.
At eight months pregnant, home was a tent in Celebration Park.
WATCH: 'I could die at any moment' (:34)
SOME MOTHERS KEEP THEIR CHILDREN
Pinon-Garcia's story of fear, shame and separation from her newborn son is common among mothers who are addicted to heroin and opiate prescription drugs, experts said. But the outcome doesn't end that way every time.
Pregnant mothers who admit to their doctor that they're abusing opiates are often directed to treatment options that increase their chance of delivering healthy babies and keeping their children.
Methadone is one preferred form of medication-assisted treatment. Buprenorphine is another. The medicine stabilizes a drug user's brain to avoid the dangerous rollercoaster cycle of heroin's highs and lows that can be deadly to a fetus.
Washington hospitals are not legally required to notify Children's Administration officials when a mother tests positive for opiates - not unless they believe the child is at risk for abuse or neglect. But when officials get the call, they're required to investigate the situation if the drugs have affected the baby.
That doesn't mean those mothers always lose custody of their children. Sometimes, social workers determine that the baby is safe to stay with his or her mother - especially if non-drug using family members are in the picture, too.
"We have something called a family decision-making meeting to really vet that process and to meet the players. We'd be looking at things like the criminal history of the other players and try to develop a plan to keep that child safe and keep them in the care of the parent," said Kiser, the intake and safety program manager at the agency.
GETTING DANIEL BACK
After she lost custody of Daniel, Pinon-Garcia went on a heroin binge.
"I smoked myself into oblivion - until I couldn't feel anything at all. 'Cause I just felt like a failure. I felt like I failed at being a mom. I failed at being a sister, a daughter, and I just didn't want to feel it," she said.
Heroin was the love of her life, and she'd do anything to get it - even if it meant skipping visits with her new son.
One day, Pinon-Garcia collapsed in a garage, with Daniel's dad by her side. She hit the cement and started convulsing.
"I just remember kind of feeling like I was asleep, and I could hear my baby's dad's voice calling my name," she said. "I thought to myself, 'I need to get into treatment. I can't put this off anymore. I'm going to die.'"
That's what it took to ask for help.
"I feel disgusted with myself honestly. Just disgusted. Like, what kind of a mother chooses drugs over her child?" she said.
At the end of May - three months after giving birth to Daniel - Pinon-Garcia got lucky. There was an open spot at Evergreen Recovery Centers in Everett.
Now that a record number of people are addicted to opiates, publicly funded treatment in some communities is hard to come by - if you don't want to wait months for a bed.
She enrolled in the six-month residential treatment program, paid for by Medicaid. It's designed for mothers addicted to drugs.
In the 23-bed facility, young children are allowed to live with their recovering moms. The women receive parenting lessons and mental health counseling as they overcome addiction.
"We know parenting can be really difficult at some points and hard to do. We get upset with our kids, but think about somebody who is learning to be clean and sober and work with a baby, too. Especially a fussy baby," said Donna Merryfield, facilities manager at Evergreen Recovery Centers.
Some moms in the program are still fighting to get their children back.
In July, Pinon-Garcia got a call that changed her life.
WATCH: 'It made being here worth it' (:22)
She finally had custody of Daniel again. It was a reunion, but it felt like the first time she laid eyes on her baby.
"Just being completely sober for the first time, being clear-headed. All of my emotions came back to me. Everything," she said.
"I had to meet my child all over again."
Today, Pinon-Garcia is almost four months sober, despite the triggers that still haunt this first-time mom.
"I don't want that life for myself. I want a future for myself and I want a future for my son and my unborn child," she said.
Did you catch that?
Pinon-Garcia is pregnant again. This time, she hopes her sobriety will keep her family together.
"I'm excited to be a mom again and that I get the opportunity to be a mom to a newborn. I didn't get to do that with Daniel," she said. " When this baby is born, we all get to go home - me, Daniel and the baby."