Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, estranged from her family, she lived in a shed she had constructed in a companion's property. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. Symptoms of withdrawal emerged. She slumped forward and vomited.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had taken the drug before arriving at the hospital and had just enough time to get treated before she was compelled to leave to use once more. She thought she still had several weeks to plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was severe, but physicians found she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is commonly used in rehabilitation.
A short time later, on the 12th of November, Stephanie gave birth to a baby girl weighing just over four pounds – premature, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been given a few hours prior to birth.
She felt sick. Not ready for motherhood. Unworthy.
Stephanie had attempted sobriety several times during pregnancy, and felt horrible each time she failed. She felt without value, criticizing herself for not being able to do the impossible. An obstetrician told her to “only” stop using. Even her dealer refused to sell to her when she became obviously with child.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her love for her baby would make her stop using only led to deeper self-loathing and negative self-talk, a trigger for her to use again. Yet she could not just wish her addiction away, any more than she could will away a long-term illness.
The infant was moved to the NICU. When Stephanie eventually visited her, she was hooked up to tubes and leads, so little she thought she would break her. Cradling her initially, she felt detached. “I gazed upon her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to give her child the name the same as her nurse, after the attendant who showed compassion to her.
Nurses and doctors told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In much of the US, where a baby is found to have infant withdrawal condition every 18 minutes, infants are still rushed to special care and given drugs while their mothers face parental assessments. But a small, growing network of centers like the care home is showing an important truth: when mothers and babies stay together, recovery succeeds, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After confirming she would be a good fit for the program, two staff members came to pick her up.
She stepped out of the hospital still in withdrawal, scared and uncertain about what would follow.
At Maddie’s Place, Stephanie still worried that authorities would come take Izzie – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could walk in and take her baby away.
For the first two weeks, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about survival. Addiction came first; trust came last.
Stephanie had a single companion, but even that connection was tenuous. The those close to her always found ways to hurt her. She did not know how to care for herself, let alone anyone else.
Each day, staff from the center took her to a treatment center, provided orally. Slowly, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed dietary support. She also had increased sensitivity and required an specialist – all common issues for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I was capable. I could be a mom.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for monitored interactions with their babies. An advocate, a peer support specialist, came over with her own five kids in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She keeps a photo of the moment. She is dressed in black pants and a hoodie, a gray knit hat with a pompom on her head, seated on the ground with the door behind her. She is lean. Her head is tilted forward so you do not see her expression. She is presenting her daughter on her leg for the children to see and they are crowding near, fawning and reaching out to the baby.
One child, eight, asked the mothers: “What about the fathers?” The parents responded that the dads were busy, called away to other tasks, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist looked at each other. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that infants need affection, then I could do this. I would become a mother.”
Approaches for managing babies with exposure have been available for years.
The evaluation method was created in 1975|
