Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, the expectant mother visited the hospital emergency room after her infection worsened 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 addicted to fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Withdrawal was setting in. She leaned over the bed and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and take a hit.”
She had consumed opioids before seeking medical help and had sufficient opportunity to get treated before she needed to go home to get high again. She thought she still had a month remaining to plan her recovery and give birth.
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 serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she departed, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in substance abuse treatment.
A short time later, on the 12th of November, Stephanie gave birth to a baby girl weighing 4lb 8oz – early, small but alive.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was emotionless. Her pain relief did not work, her final administration of fentanyl had been provided four hours before delivery.
She felt unwell. Unprepared to be a mother. Not fit.
Stephanie had attempted sobriety several times during pregnancy, and felt awful each time she was unsuccessful. She felt without value, berating herself for not being able to achieve the unattainable. An OBGYN told her to “just” stop using. Even her dealer refused to sell to her when she became obviously with child.
“However, I failed,” she said. “I had to seek support.”
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 relapse. Yet she could not easily command her addiction away, any more than she could eliminate a long-term illness.
The infant was moved to the special care nursery. When Stephanie eventually visited her, she was connected to tubes and leads, so little she thought she would break 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 name her baby Izzie, after the nurse who had been so kind to her.
Nurses and doctors told her about a specialized facility, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In many parts of America, where a baby is found to have neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and given drugs while their mothers face custody evaluations. But a developing system of centers like this facility is showing an important truth: when parents and infants remain united, recovery succeeds, foster placements fall and long-term costs decline.
It took Stephanie some time to build confidence to call, but she eventually made the call. After ensuring she qualified for the program, care providers came to collect her.
She left the medical center still in withdrawal, anxious and doubtful about what would happen next.
At the care center, Stephanie still was concerned that authorities would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could walk in and take her baby away.
For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about getting by. Drugs came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The individuals she cared for always found ways to let her down. She did not know how to love herself, not to mention anyone else.
Daily, staff from Maddie’s Place took her to a clinic for methadone, provided orally. Slowly, she was beginning recovery.
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 adverse reactions to milk and obvious stomach troubles. She needed feeding therapy. She also had heightened sensory issues and required an professional – all typical problems for babies exposed to substances.
Seeing that even a young person understands the need for care, then I found the strength. I could be a mom.
During a pre-holiday visit, Stephanie remained in the shared space, where parents in active addiction can come for monitored interactions with their babies. An advocate, a mentor, visited with her own five kids in tow to bring treats. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in wonder of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is wearing casual attire, a gray knit hat with a pompom 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, admiring and touching to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The women attempted to clarify that the men were occupied, handling responsibilities, that they would be there given the chance.
“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 the specialist looked at each other. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that infants need affection, then I could do this. I could parent.”
Methods to address infants affected by substances have existed for decades.
The Finnegan NAS scale was established in 1975|
