Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
Pregnant and experiencing intense discomfort, a woman named Stephanie visited the ER after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she lived in a shed she had assembled in a companion's property. She was also addicted to fentanyl.
As medical staff managed her infection, she began to panic. The onset of withdrawal began. She bent over the bedside and became sick.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and take a hit.”
She had used fentanyl before arriving at the hospital and had just enough time to get treated before she had to return to relapse. She thought she still had several weeks to plan her recovery and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the infection in her legs was severe, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be placed on methadone, a treatment that reduces symptoms and is often prescribed in substance abuse treatment.
Five days later, on the 12th of November, Stephanie had a baby girl weighing a small weight – early, small but alive.
When the nurse asked if she wanted to embrace her child, Stephanie said “no.” She was emotionless. Her pain relief did not work, her final administration of fentanyl had been provided four hours before delivery.
She felt sick. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she was unsuccessful. She felt without value, berating herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her supplier refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
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 will away a persistent condition.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was hooked up to monitors, so little she thought she would harm her. Holding her for the first time, she felt empty. “I looked at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to give her child the name Izzie, after the professional who provided support to her.
Nurses and doctors told her about a specialized facility, 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 diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still quickly moved to hospitals and given drugs while their mothers face custody evaluations. But a limited but expanding group of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, outcomes improve, fewer children enter care and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After confirming she would be a good fit for the program, two staff members came to collect her.
She departed the institution still in withdrawal, scared and uncertain about what would come next.
At the facility, Stephanie still was concerned that child services would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any point, someone could walk in and take her baby away.
For the beginning period, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about enduring. Drugs 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 did not know how to love herself, not to mention anyone else.
Every day, staff from Maddie’s Place took her to a treatment center, administered in pill form. Slowly, she was beginning recovery.
She spent every minute outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and severe digestive problems. She needed nutritional guidance. She also had sensory challenges and required an specialist – all typical problems for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I could do this. I could parent.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. A support specialist, a recovery coach, stopped by with her own family in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in wonder of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She keeps a photo of the moment. She is dressed in casual attire, a cap with a bobble on her head, sitting on the wooden floor with the door behind her. She is slender. Her posture is humble so you do not see her expression. She is holding Izzie up on her knee for the other kids to see and they are gathered around, showing interest to the baby.
Jacob, eight, asked the moms: “What about the fathers?” 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 plan to be a great parent. They will know they are valued.”
Stephanie and Bunch-Smith made eye contact. “I became emotional,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.”
Methods to address drug-exposed newborns have been used for a long time.
The assessment tool was developed in 1975|