Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Transformed Their Futures.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the ER after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she stayed in a makeshift shelter she had assembled in a acquaintance's garden. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She bent over the bedside and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and get high.”
She had taken the drug before seeking medical help and had sufficient opportunity to get treated before she had to return to relapse. She thought she still had a month remaining to find a way to become sober and deliver her child.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was serious, but physicians found she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.
A short time later, on the 12th of November, Stephanie had a daughter weighing just over four pounds – premature, tiny yet healthy.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her anesthesia was ineffective, her last dose of fentanyl had been given four hours before delivery.
She felt unwell. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety several times during pregnancy, and felt awful each time she was unsuccessful. She felt hopeless, criticizing herself for not being able to do the impossible. An obstetrician told her to “just” stop using. Even her source refused to sell to her when she became clearly expecting.
“But I couldn’t,” she said. “I required assistance.”
The widespread belief that her love for her baby would make her recover only led to greater shame and self-abuse, a impetus for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a long-term illness.
The infant was moved to the neonatal intensive care unit. When Stephanie finally saw her her, she was connected to tubes and leads, so tiny she thought she would break her. Embracing her at last, she felt nothing. “I just stared at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Two days later she decided to call her daughter the same as her nurse, after the professional who provided support to her.
Nurses and doctors told her about a care center, a unique recovery environment where women and their babies are treated together, not apart.
In much of the US, where a baby is identified with newborn addiction symptoms regularly, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a developing system of centers like this facility is showing an important truth: when parents and infants remain united, results get better, foster placements fall and long-term costs decline.
It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, two staff members came to bring her to the facility.
She left the medical center still in recovery, scared and uncertain about what would follow.
At Maddie’s Place, Stephanie still feared that child services would come take Izzie – even though she was not sure she wanted to keep her. The fear lingered: that at any moment, someone could arrive and separate them.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about survival. Substances came first; reliance came last.
Stephanie had a trusted ally, but even that relationship was delicate. The people she loved always found ways to let her down. She was unable to value herself, not to mention anyone else.
Each day, staff from the facility took her to a clinic for methadone, administered in pill form. Gradually, she was starting to get clean.
She spent every minute outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed dietary support. She also had heightened sensory issues and required an professional – all common issues for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.
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 mentor, stopped by with her own five kids in tow to deliver baked goods. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in wonder of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She holds a picture of the moment. She is clad in casual attire, a beanie with a bobble on her head, resting on the floor with the exit nearby. She is lean. Her posture is humble so you do not see her expression. She is holding Izzie up on her knee for the young ones to see and they are crowding near, showing interest to the baby.
Jacob, eight, asked the mothers: “What about the fathers?” The parents responded that the dads were busy, handling responsibilities, that they would be there given the chance.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I found the courage. I could parent.”
Methods to address infants affected by substances have existed for decades.
The assessment tool was created in 1975|
