Fentanyl Addiction During Pregnancy: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, the expectant mother went to the ER after a serious infection started to spread up her legs. Unemployed and homeless, cut off from her relatives, she lived in a shed she had assembled in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she started to feel anxious. The onset of withdrawal began. She bent over the bedside and threw up.
Stephanie finally broke down. “I have to get out of here. I have to go home and get high.”
She had consumed opioids 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 four weeks left to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the leg infection was critical, but doctors had discovered she also had an amniotic fluid leak. The nurse, 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 periodically, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is commonly used in addiction recovery.
After five days, on the 12th of November, Stephanie delivered a infant weighing just over four pounds – born before term, little but surviving.
When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was numb. Her pain relief did not work, her final administration of fentanyl had been administered shortly before she gave birth.
She felt ill. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety several times during pregnancy, and felt terrible each time she failed. She felt hopeless, berating herself for not being able to do the impossible. An doctor told her to “simply” stop using. Even her supplier refused to sell to her when she became visibly pregnant.
“But I couldn’t,” she said. “I required assistance.”
The common assumption that her bond with her newborn would make her quit only led to deeper self-loathing and negative self-talk, a impetus for her to return to drugs. Yet she could not easily command her addiction away, any more than she could overcome a persistent condition.
The infant was moved to the special care nursery. When Stephanie at last met her, she was connected to medical equipment, so tiny she thought she would hurt her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to call her daughter after her caregiver, after the nurse who had been so kind to her.
Hospital staff told her about Maddie’s Place, a unique recovery environment where women and their babies are cared for jointly, not apart.
In numerous states, where a baby is identified with newborn addiction symptoms frequently, infants are still whisked to NICUs and given drugs while their mothers face child-protection investigations. But a small, growing network of centers like this facility is showing an important truth: when parents and infants remain united, results get better, fewer children enter care and long-term costs decline.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After confirming she would be a good fit 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 happen next.
At the facility, Stephanie still was concerned that authorities would come remove her daughter – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, 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 getting by. Drugs came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She was unable to care for herself, not to mention anyone else.
Each day, staff from Maddie’s Place took her to a recovery program, given as medication. Slowly, she was starting to get clean.
She devoted all her time when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an specialist – all frequent conditions for babies affected by withdrawal.
Seeing that even a young person understands the need for care, 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. A support specialist, a mentor, stopped by with her own family in tow to deliver baked goods. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in admiration of the little newborn 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 black pants and a hoodie, a cap with a bobble on her head, sitting on the wooden floor with the door behind her. She is thin. Her posture is humble so you miss her features. She is lifting the baby on her leg for the other kids to see and they are standing close, fawning and reaching out to the baby.
A young boy, eight, asked the moms: “Where are all the dads?” The parents responded that the dads were busy, handling responsibilities, that they would be there if possible.
“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and her companion made eye contact. “I broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I could do this. I could parent.”
Approaches for managing drug-exposed newborns have been available for years.
The assessment tool was created in 1975|
