Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the ER 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 friend’s yard. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. The onset of withdrawal began. She leaned over the bed and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had taken the drug before coming to the ER and had sufficient opportunity to get treated before she needed to go home to get high again. She thought she still had four weeks left to find a way to become sober and give birth.
The medical professional intervened. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but physicians found she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.
A short time later, on the 12th of November, Stephanie delivered a baby girl weighing just over four pounds – born before term, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was detached. Her pain relief did not work, her final administration of fentanyl had been administered four hours before delivery.
She felt unwell. Unprepared to be a mother. Not fit.
Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she failed. She felt without value, blaming herself for not being able to achieve the unattainable. An obstetrician told her to “only” stop using. Even her supplier declined to supply to her when she became visibly pregnant.
“However, I failed,” she said. “I required assistance.”
The pervasive expectation that her affection for her child would make her recover only led to greater shame and self-abuse, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a long-term illness.
The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was hooked up to monitors, so tiny she thought she would harm her. Embracing her at last, she felt nothing. “I looked at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to name her baby Izzie, after the professional who provided support to her.
Nurses and doctors told her about Maddie’s Place, a unique recovery environment where parents and infants affected by substance use are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still whisked to NICUs and medicated while their mothers face custody evaluations. But a limited but expanding group of centers like this facility is demonstrating a key fact: when mothers and babies stay together, outcomes improve, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After ensuring she qualified for the program, care providers came to pick her up.
She departed the institution still in recovery, anxious and doubtful about what would happen next.
At the care center, Stephanie still feared that child services would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any time, someone could arrive and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about survival. Drugs came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She did not know how to care for herself, much less anyone else.
Every day, staff from Maddie’s Place transported her to a recovery program, given as medication. Gradually, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed nutritional guidance. She also had increased sensitivity and required an specialist – all typical problems for babies affected by withdrawal.
When a child recognizes these infants need affection, then I found the strength. I could parent.
During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for monitored interactions with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own family in tow to drop off cookies. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” 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 clad in casual attire, a beanie with a pompom on her head, seated on the ground with the entryway at her back. She is lean. Her posture is humble so you cannot see her face. She is presenting her daughter on her leg for the children to see and they are gathered around, showing interest to the baby.
Jacob, eight, asked the moms: “Why are there no men?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there given the chance.
“When I have kids,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and her companion made eye contact. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I could do this. I could be a mom.”
Methods to address babies with exposure have existed for decades.
The evaluation method was developed in 1975|
