Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, the expectant mother visited the medical facility after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she lived in a shed she had assembled in a friend’s yard. She was also hooked on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She slumped forward and threw up.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and take a hit.”
She had taken the drug before coming to the ER and had only a brief window to get treated before she was compelled to leave to use once more. She thought she still had a month remaining to find a way to become sober and deliver her child.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was severe, but doctors had discovered she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she departed, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is often prescribed in rehabilitation.
A short time later, on the 12th of November, Stephanie gave birth to a daughter weighing 4lb 8oz – early, small but alive.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was numb. Her pain relief did not work, her last dose of fentanyl had been provided shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Undeserving.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she relapsed. She felt without value, blaming herself for not being able to achieve the unattainable. An OBGYN told her to “simply” stop using. Even her source declined to supply to her when she became clearly expecting.
“However, I failed,” she said. “I needed help.”
The widespread belief that her bond with her newborn would make her recover 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 long-term illness.
The infant was moved to the neonatal intensive care unit. When Stephanie finally saw her her, she was connected to medical equipment, so small she thought she would hurt her. Embracing her at last, she felt detached. “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 after her caregiver, after the professional who provided support to her.
Medical personnel told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a small, growing network of centers like the care home is proving a simple point: when parents and infants remain united, outcomes improve, fewer children enter care and future expenses reduce.
It took Stephanie a period to find strength to call, but she finally did. After verifying her eligibility for the program, care providers came to collect her.
She departed the institution still in recovery, anxious and doubtful about what would follow.
At the care center, Stephanie still feared that authorities would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could enter and remove her child.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I was suspicious at that point.”
Homelessness, she said, was about survival. Addiction came first; faith came last.
Stephanie had a trusted ally, but even that connection was tenuous. The people she loved always found ways to let her down. She was unable to love herself, much less anyone else.
Daily, staff from Maddie’s Place transported her to a clinic for methadone, given as medication. Slowly, she was embracing sobriety.
She devoted all her time beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an specialist – all common issues for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I found the strength. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for supervised visits with their babies. A support specialist, a recovery coach, stopped by with her own family in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in wonder of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She keeps a photo of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a bobble on her head, resting on the floor with the entryway at her back. She is thin. Her head is tilted forward so you cannot see her face. She is holding Izzie up on her knee for the other kids to see and they are crowding near, fawning and reaching out to the baby.
One child, eight, asked the parents: “Why are there no men?” The women attempted to clarify that the dads were busy, handling responsibilities, that they would be there if possible.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I could be a mom.”
Methods to address drug-exposed newborns have been used for a long time.
The assessment tool was developed in 1975|