Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the ER after an infection began spreading up her legs. Unemployed and homeless, cut off from her relatives, she lived in a shed she had built in a companion's property. She was also dependent on fentanyl.
As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and vomited.
Stephanie eventually collapsed. “I need to leave. I have to go home and get high.”
She had consumed opioids before coming to the ER and had only a brief window to get treated before she needed to go home to get high again. She thought she still had a month remaining to figure out how to get clean and have this baby.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was critical, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she left, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be placed on methadone, a medication that eases withdrawal and is frequently utilized in rehabilitation.
Five days later, on the 12th of November, Stephanie had a baby girl weighing just over four pounds – early, little but surviving.
When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was numb. Her epidural had failed, her last dose of fentanyl had been provided four hours before delivery.
She felt unwell. Ill-equipped for parenting. 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 achieve the unattainable. An doctor told her to “simply” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I needed help.”
The common assumption that her affection for her child would make her recover only led to deeper self-loathing and self-abuse, a trigger for her to return to drugs. Yet she could not simply will her addiction away, any more than she could eliminate a chronic disease.
The newborn was transferred to the NICU. When Stephanie finally saw her her, she was attached to medical equipment, so tiny 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 still wasn’t sure she wanted to be her mother.
After two days she decided to call her daughter after her caregiver, after the attendant who showed compassion to her.
Hospital staff told her about a care center, a innovative treatment home where women and their babies are treated together, not apart.
In many parts of America, where a baby is identified with newborn addiction symptoms every 18 minutes, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a developing system of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, results get better, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, a couple of employees came to bring her to the facility.
She departed the institution still in detox, anxious and doubtful about what would happen next.
At the facility, Stephanie still feared that CPS would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any time, someone could enter and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about enduring. Drugs came first; trust came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to cause pain. She lacked the ability to love herself, not to mention anyone else.
Each day, staff from Maddie’s Place took her to a recovery program, given as medication. Gradually, she was embracing sobriety.
She utilized each moment outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with adverse reactions to milk and severe digestive problems. She needed feeding therapy. She also had increased sensitivity and required an professional – all common issues for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I was capable. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for guided meetings with their babies. A support specialist, a mentor, came over with her own family in tow to drop off cookies. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in admiration of the tiny infant 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 wearing black pants and a hoodie, a beanie with a pompom on her head, sitting on the wooden floor with the exit nearby. She is slender. Her posture is humble so you miss her features. She is holding Izzie up on her leg for the young ones to see and they are crowding near, admiring and touching to the baby.
Jacob, eight, asked the mothers: “What about the fathers?” The parents responded that the men were occupied, engaged elsewhere, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that newborns require care, then I was able. I would become a mother.”
Approaches for managing babies with exposure have existed for decades.
The assessment tool was created in 1975|
