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. Jobless and without shelter, estranged from her family, she resided in a small structure she had assembled in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She leaned over the bed and became sick.
Stephanie finally broke down. “I have to get out of here. I have to go home and use drugs.”
She had used fentanyl before seeking medical help and had only a brief window to get treated before she was compelled to leave to use once more. She thought she still had a month remaining to find a way to become sober and deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was severe, but medical staff detected she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she departed, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be transitioned to methadone, a medication that eases withdrawal and is frequently utilized in addiction recovery.
Five days later, on the 12th of November, Stephanie had a infant weighing a small weight – early, small but alive.
When the nurse asked if she wanted to hold her baby, Stephanie said “I cannot.” She was detached. Her pain relief did not work, her last dose of fentanyl had been administered a few hours prior to birth.
She felt unwell. Unprepared to be a mother. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she failed. She felt worthless, berating herself for not being able to achieve the unattainable. An OBGYN told her to “just” stop using. Even her supplier refused to sell to her when she became clearly expecting.
“Yet I was unable,” she said. “I required assistance.”
The pervasive expectation that her affection for her child would make her recover only led to greater shame and negative self-talk, a trigger for her to use again. Yet she could not simply will her addiction away, any more than she could overcome a long-term illness.
The baby was taken to the NICU. When Stephanie finally saw her her, she was attached to tubes and leads, so small she thought she would harm her. Holding her for the first time, she felt empty. “I just stared at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to call her daughter Izzie, after the nurse who had been so kind to her.
Medical personnel told her about Maddie’s Place, a unique recovery environment where parents and infants affected by substance use are supported as a unit, not apart.
In many parts of America, where a baby is found to have newborn addiction symptoms every 18 minutes, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a developing system of centers like the care home is proving a simple point: when mothers and babies stay together, recovery succeeds, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, a couple of employees came to bring her to the facility.
She departed the institution still in recovery, anxious and doubtful 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 fear lingered: that at any time, someone could enter and remove her child.
For the first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Addiction came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to let her down. She lacked the ability to love herself, much less anyone else.
Every day, staff from Maddie’s Place took her to a recovery program, administered in pill form. Gradually, she was embracing sobriety.
She spent every minute when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed nutritional guidance. She also had sensory challenges and required an professional – all typical problems for babies affected by withdrawal.
When a child recognizes these infants need affection, then I was capable. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for guided meetings with their babies. An advocate, a peer support specialist, came over with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in awe of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She keeps a photo of the moment. She is wearing black pants and a hoodie, a cap with a decoration on her head, resting on the floor with the exit nearby. She is thin. Her posture is humble so you do not see her expression. She is lifting the baby on her leg for the young ones to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the moms: “Where are all the dads?” The moms tried to explain that the dads were busy, called away to other tasks, that they would be there if they could.
“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and her companion exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I was able. I would become a mother.”
Tools for treating babies with exposure have been available for years.
The Finnegan NAS scale was developed in 1975|
