Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Rescued Both Lives.
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, estranged from her family, she stayed in a makeshift shelter she had constructed in a companion's property. She was also dependent on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Withdrawal was setting in. She bent over the bedside and threw up.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and take a hit.”
She had consumed opioids before coming to the ER and had only a brief window to get treated before she had to return to use once more. 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 am leaving,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was critical, but medical staff detected she also had an ruptured membrane. The nurse, her nurse, warned her: if she walked out, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
A short time later, on the 12th of November, Stephanie had a baby girl weighing 4lb 8oz – premature, tiny yet healthy.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “not now.” She was emotionless. Her epidural had failed, her previous intake of fentanyl had been given four hours before delivery.
She felt sick. Ill-equipped for parenting. Unworthy.
Stephanie had sought recovery repeatedly before birth, and felt awful each time she was unsuccessful. She felt worthless, berating herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her supplier declined to supply to her when she became clearly expecting.
“But I couldn’t,” she said. “I required assistance.”
The widespread belief that her bond with her newborn would make her quit only led to increased guilt and negative self-talk, a impetus for her to use again. Yet she could not just wish her addiction away, any more than she could eliminate a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie at last met her, she was connected to monitors, so small she thought she would break her. Cradling her initially, she felt empty. “I gazed upon her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to name her baby the same as her nurse, after the nurse who had been so kind to her.
Nurses and doctors told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are treated together, not apart.
In much of the US, where a baby is found to have neonatal abstinence syndrome (NAS) every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face child-protection investigations. But a small, growing network of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, outcomes improve, fewer children enter care and overall savings increase.
It took Stephanie some time to build confidence to call, but she finally did. After ensuring she qualified for the program, two staff members came to bring her to the facility.
She departed the institution still in recovery, fearful and unsure about what would follow.
At the care center, Stephanie still worried that CPS would come take Izzie – even though she was hesitant about parenting. The concern persisted: that at any moment, someone could arrive and remove her child.
For the first two weeks, Stephanie kept to herself. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about survival. Addiction came first; reliance came last.
Stephanie had one close friend, but even that bond was fragile. The people she loved always found ways to let her down. She lacked the ability to value herself, let alone anyone else.
Each day, staff from the facility transported her to a recovery program, given as medication. Over time, she was starting to get clean.
She spent every minute outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had increased sensitivity and required an specialist – all frequent conditions for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could be a mom.
On a day prior to the holiday, Stephanie sat in the visitation area, where individuals struggling with substance use can come for guided meetings with their babies. Katie Bunch-Smith, a peer support specialist, stopped by with her own five kids in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in wonder of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She holds a picture of the moment. She is wearing dark trousers and a sweatshirt, a beanie with a decoration on her head, resting on the floor with the exit nearby. She is lean. Her head is tilted forward so you miss her features. She is lifting the baby on her lap for the other kids to see and they are gathered around, admiring and touching to the baby.
A young boy, eight, asked the parents: “Where are all the dads?” The women attempted to clarify that the fathers had obligations, handling responsibilities, that they would be there given the chance.
“When I have kids,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and the specialist made eye contact. “I broke down,” 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 drug-exposed newborns have been used for a long time.
The assessment tool was created in 1975|
