Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Saved Them Both.
Eight months pregnant and in severe pain, the expectant mother visited the ER after a serious infection started to spread up her legs. Without a job or home, cut off from her relatives, she stayed in a makeshift shelter she had built in a companion's property. She was also hooked on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and take a hit.”
She had taken the drug before arriving at the hospital and had sufficient opportunity to get treated before she was compelled to leave to relapse. She thought she still had several weeks to find a way to become sober and deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the infection in her legs was severe, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in addiction recovery.
A short time later, on the 12th of November, Stephanie delivered a infant weighing a small weight – early, small but alive.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her pain relief did not work, her final administration of fentanyl had been administered shortly before she gave birth.
She felt sick. Unprepared to be a mother. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she relapsed. She felt without value, blaming herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her supplier refused to sell to her when she became visibly pregnant.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her affection for her child would make her quit only led to deeper self-loathing and negative self-talk, a cause 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 infant was moved to the special care nursery. When Stephanie eventually visited her, she was hooked up to tubes and leads, so small she thought she would harm her. Cradling her initially, she felt empty. “I gazed upon her and was like, ‘What am I going to do with you?’” 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 attendant who showed compassion to her.
Nurses and doctors told her about a care center, a new kind of care center where parents and infants affected by substance use are treated together, not apart.
In many parts of America, where a baby is identified with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face custody evaluations. But a small, growing network of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, results get better, foster placements fall and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in detox, anxious and doubtful about what would come next.
At Maddie’s Place, Stephanie still was concerned that authorities would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any time, someone could walk in and separate them.
For the beginning period, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about enduring. Drugs came first; faith came last.
Stephanie had one close friend, but even that relationship was delicate. The those close to her always found ways to hurt her. She did not know how to care for herself, let alone anyone else.
Every day, staff from the center transported her to a treatment center, given as medication. Over time, she was starting to get clean.
She spent every minute beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and obvious stomach troubles. She needed dietary support. She also had sensory challenges and required an professional – all typical problems for babies affected by withdrawal.
When a child recognizes these infants need affection, then I was capable. I could parent.
During a pre-holiday visit, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. Katie Bunch-Smith, a mentor, stopped by with her own children in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in wonder of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She keeps a photo of the moment. She is dressed in casual attire, a gray knit hat with a pompom on her head, resting on the floor with the entryway at her back. She is thin. Her posture is humble so you miss her features. She is lifting the baby on her lap for the young ones to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the moms: “Where are all the dads?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if they could.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I was able. I would become a mother.”
Approaches for managing babies with exposure have been available for years.
The assessment tool was established in 1975|
