Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
In her eighth month of pregnancy and suffering, the expectant mother visited the ER after an infection began spreading up her legs. Unemployed and homeless, separated from loved ones, she stayed in a makeshift shelter she had assembled in a acquaintance's garden. She was also addicted to fentanyl.
As doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and vomited.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and get high.”
She had used fentanyl before arriving at the hospital and had just enough time to get treated before she was compelled to leave to relapse. She thought she still had several weeks to find a way to become sober and give birth.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was serious, 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 be at risk of death.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.
Five days later, on 12 November 2022, Stephanie had a infant weighing a small weight – premature, small but alive.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her epidural had failed, her final administration of fentanyl had been administered four hours before delivery.
She felt unwell. Ill-equipped for parenting. Unworthy.
Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she relapsed. She felt without value, blaming herself for not being able to do the impossible. An doctor told her to “simply” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her recover only led to increased guilt and negative self-talk, a trigger for her to return to drugs. Yet she could not easily command her addiction away, any more than she could eliminate a chronic disease.
The infant was moved to the neonatal intensive care unit. When Stephanie finally saw her her, she was attached to medical equipment, so little she thought she would hurt her. Holding her for the first time, she felt detached. “I just stared at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
After two days 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 innovative treatment home where women and their babies are cared for jointly, not apart.
In many parts of America, where a baby is found to have infant withdrawal condition every 18 minutes, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like Maddie’s Place is proving a simple point: when mothers and babies stay together, recovery succeeds, foster placements fall and long-term costs decline.
It took Stephanie a period to find strength to call, but she finally did. After verifying her eligibility for the program, care providers came to pick her up.
She left the medical center still in withdrawal, anxious and doubtful about what would follow.
At the facility, Stephanie still feared that CPS would come seize her child – 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 remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about getting by. Substances came first; reliance came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to hurt her. She did not know how to value herself, much less anyone else.
Every day, staff from the center took her to a recovery program, given as medication. Over time, she was starting to get clean.
She utilized each moment outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had sensory challenges and required an specialist – all frequent conditions for babies born with NAS.
Seeing that even a young person understands the need for care, then I found the strength. I would become a mother.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, visited with her own family in tow to deliver baked goods. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in wonder of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She has an image of the moment. She is clad in black pants and a hoodie, a cap with a bobble on her head, seated on the ground with the exit nearby. She is thin. Her head is tilted forward so you cannot see her face. She is lifting the baby on her knee for the children to see and they are standing close, admiring and touching to the baby.
Jacob, 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 possible.
“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. “If this little kid could see that newborns require care, then I could do this. I would become a mother.”
Methods to address infants affected by substances have been used for a long time.
The Finnegan NAS scale was established in 1975|
