Fentanyl Addiction During Pregnancy: How Keeping Her Baby Rescued Both Lives.
Eight months pregnant and in severe pain, the expectant mother visited the hospital emergency room after her infection worsened up her legs. Without a job or home, separated from loved ones, she lived in a shed she had constructed in a companion's property. She was also dependent on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and became sick.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had sufficient opportunity to get treated before she needed to go home to use once more. She thought she still had a month remaining to figure out how to get clean and give birth.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was severe, but physicians found she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a medication that eases withdrawal and is often prescribed in substance abuse treatment.
A short time later, on the 12th of November, Stephanie delivered a infant weighing just over four pounds – early, tiny yet healthy.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been given four hours before delivery.
She felt ill. Not ready for motherhood. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt horrible each time she failed. She felt hopeless, blaming herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her source refused to sell to her when she became clearly expecting.
“But I couldn’t,” she said. “I needed help.”
The pervasive expectation that her bond with her newborn would make her quit only led to greater shame and self-harm, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.
The infant was moved to the neonatal intensive care unit. When Stephanie finally saw her her, she was connected to monitors, so little she thought she would hurt her. Holding her for the first time, she felt nothing. “I looked at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
After two days she decided to name her baby after her caregiver, after the nurse who had been so kind to her.
Nurses and doctors told her about a specialized facility, a unique recovery environment where women and their babies are supported as a unit, not apart.
In much of the US, where a baby is diagnosed with newborn addiction symptoms regularly, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is proving a simple point: when mothers and babies stay together, results get better, foster placements fall and future expenses reduce.
It took Stephanie a period to find strength to call, but she ultimately reached out. After verifying her eligibility for the program, a couple of employees came to collect her.
She departed the institution still in recovery, fearful and unsure about what would happen next.
At the facility, Stephanie still feared that CPS would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could enter and separate them.
For the initial fortnight, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about getting by. Substances came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The those close to her always found ways to hurt her. She lacked the ability to care for herself, let alone anyone else.
Each day, staff from Maddie’s Place took her to a clinic for methadone, administered in pill form. Over time, she was starting to get clean.
She devoted all her time when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and severe digestive problems. She needed feeding therapy. She also had sensory challenges and required an professional – all frequent conditions for babies born with NAS.
Seeing that even a young person understands the need for care, then I was capable. I could be a mom.
On a day prior to the holiday, Stephanie remained in the shared space, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a recovery coach, stopped by with her own five kids in tow to deliver baked goods. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The young ones stared in wonder of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She has an image of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a pompom on her head, resting on the floor with the door behind her. She is lean. Her head is tilted forward so you miss her features. She is presenting her daughter on her lap for the children to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the mothers: “What about the fathers?” The women attempted to clarify that the dads were busy, engaged elsewhere, that they would be there if they could.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and her companion exchanged glances. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that newborns require care, then I was able. I would become a mother.”
Approaches for managing drug-exposed newborns have been used for a long time.
The evaluation method was created in 1975|
