Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.
In her eighth month of pregnancy and suffering, the expectant mother visited the hospital emergency room after a serious infection started to spread up her legs. Unemployed and homeless, estranged from her family, she stayed in a makeshift shelter she had built in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and became sick.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and get high.”
She had taken the drug before arriving at the hospital and had just enough time to get treated before she had to return to use once more. She thought she still had four weeks left to plan her recovery and give birth.
The medical professional intervened. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the leg infection was critical, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be switched to methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.
After five days, on the 12th of November, Stephanie had a infant weighing just over four pounds – early, tiny yet healthy.
When the attendant inquired if she wanted to embrace her child, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her final administration of fentanyl had been given four hours before delivery.
She felt ill. Unprepared to be a mother. Undeserving.
Stephanie had attempted sobriety several times during pregnancy, and felt awful each time she failed. She felt hopeless, criticizing herself for not being able to achieve the unattainable. An obstetrician told her to “simply” stop using. Even her supplier refused to sell to her when she became visibly pregnant.
“Yet I was unable,” she said. “I needed help.”
The pervasive expectation that her bond with her newborn would make her quit only led to deeper self-loathing and self-harm, a impetus for her to return to drugs. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the special care nursery. When Stephanie eventually visited her, she was connected to medical equipment, so little she thought she would break her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to give her child the name after her caregiver, after the nurse who had been so kind to her.
Nurses and doctors told her about a specialized facility, a new kind of care center where mothers and their drug-exposed newborns are treated together, not apart.
In many parts of America, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still rushed to special care and given drugs while their mothers face parental assessments. But a limited but expanding group of centers like Maddie’s Place is demonstrating a key fact: when families are kept intact, outcomes improve, fewer children enter care and long-term costs decline.
It took Stephanie a period to find strength to call, but she eventually made the call. After ensuring she qualified for the program, care providers came to collect her.
She departed the institution still in withdrawal, scared and uncertain about what would come next.
At the care center, Stephanie still was concerned that authorities would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could enter and remove her child.
For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about survival. Addiction came first; reliance came last.
Stephanie had a trusted ally, but even that connection was tenuous. The those close to her always found ways to cause pain. She was unable to love herself, much less anyone else.
Each day, staff from the center drove her to a treatment center, administered in pill form. Slowly, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and severe digestive problems. She needed nutritional guidance. She also had sensory challenges and required an occupational therapist – all common issues for babies exposed to substances.
Seeing that even a young person understands the need for care, then I found the strength. I could parent.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where individuals struggling with substance use can come for monitored interactions with their babies. An advocate, a recovery coach, came over with her own children in tow to drop off cookies. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in awe of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, resting on the floor with the exit nearby. She is lean. Her posture is humble so you cannot see her face. She is holding Izzie up on her knee for the young ones to see and they are gathered around, showing interest to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The women attempted to clarify that the fathers had obligations, called away to other tasks, that they would be there if they could.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I could parent.”
Methods to address infants affected by substances have been used for a long time.
The evaluation method was developed in 1975|
