Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Saved Them Both.
Eight months pregnant and in severe pain, a woman named Stephanie went to the hospital emergency room 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 companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. She bent over the bedside and vomited.
Stephanie finally broke down. “I need to leave. I have to go home and take a hit.”
She had taken the drug before arriving at the hospital and had just enough time to get treated before she had to return to get high again. She thought she still had several weeks to plan her recovery and have this baby.
The medical professional intervened. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was serious, but doctors had discovered she also had an ruptured membrane. The nurse, her nurse, warned her: if she walked out, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
Five days later, on the 12th of November, Stephanie had a infant weighing a small weight – early, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “not now.” She was detached. Her anesthesia was ineffective, her final administration of fentanyl had been given a few hours prior to birth.
She felt sick. Ill-equipped for parenting. Unworthy.
Stephanie had tried to get clean repeatedly before birth, and felt awful each time she failed. She felt worthless, berating herself for not being able to do the impossible. An OBGYN told her to “only” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“But I couldn’t,” she said. “I required assistance.”
The common assumption that her affection for her child would make her stop using only led to deeper self-loathing and self-abuse, a cause for her to return to drugs. Yet she could not easily command her addiction away, any more than she could will away a chronic disease.
The baby was taken to the special care nursery. When Stephanie eventually visited her, she was attached to tubes and leads, so little she thought she would hurt her. Cradling her initially, she felt detached. “I looked at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Two days later she decided to call her daughter Izzie, after the nurse who had been so kind to her.
Medical personnel told her about a care center, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In much of the US, where a baby is identified with infant withdrawal condition regularly, infants are still quickly moved to hospitals and given drugs while their mothers face custody evaluations. But a small, growing network of centers like Maddie’s Place is showing an important truth: when families are kept intact, results get better, custody cases decrease and future expenses reduce.
It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to collect her.
She left the medical center still in withdrawal, scared and uncertain about what would come next.
At the facility, Stephanie still feared that authorities would come remove her daughter – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could enter and remove her child.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about getting by. Addiction came first; reliance came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to cause pain. She was unable to love herself, let alone anyone else.
Daily, staff from Maddie’s Place took her to a recovery program, provided orally. Over time, she was beginning recovery.
She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and obvious stomach troubles. She needed feeding therapy. She also had heightened sensory issues and required an specialist – all common issues for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I was capable. I would become a mother.
On a day prior to the holiday, Stephanie remained in the shared space, where those still using can come for guided meetings with their babies. An advocate, a mentor, visited with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She holds a picture of the moment. She is dressed in dark trousers and a sweatshirt, a cap with a decoration on her head, seated on the ground with the entryway at her back. She is lean. Her face is downcast so you miss her features. She is lifting the baby on her knee for the other kids to see and they are gathered around, admiring and touching to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The parents responded that the dads were busy, 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 her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that newborns require care, then I could do this. I would become a mother.”
Methods to address drug-exposed newborns have been used for a long time.
The assessment tool was created in 1975|
