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 hospital emergency room after an infection began spreading up her legs. Without a job or home, separated from loved ones, she resided in a small structure she had constructed in a companion's property. She was also addicted to fentanyl.
As doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She bent over the bedside and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and get high.”
She had taken the drug before seeking medical help and had only a brief window to get treated before she was compelled to leave to relapse. She thought she still had a month remaining to plan her recovery and have this baby.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was critical, but physicians found she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in rehabilitation.
Five days later, on a day in November 2022, Stephanie had a baby girl weighing 4lb 8oz – born before term, small but alive.
When the attendant inquired if she wanted to embrace her child, Stephanie said “not now.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been administered a few hours prior to birth.
She felt ill. Not ready for motherhood. Not fit.
Stephanie had tried to get clean repeatedly before birth, and felt horrible each time she failed. She felt without value, blaming herself for not being able to do the impossible. An doctor told her to “simply” stop using. Even her supplier declined to supply to her when she became obviously with child.
“Yet I was unable,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her stop using only led to increased guilt and self-abuse, a cause for her to relapse. Yet she could not easily command her addiction away, any more than she could will away a persistent condition.
The infant was moved to the special care nursery. When Stephanie eventually visited her, she was connected to medical equipment, so small she thought she would harm her. Embracing her at last, she felt nothing. “I looked at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to call her daughter Izzie, after the nurse who had been so kind to her.
Medical personnel told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a limited but expanding group of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, results get better, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After confirming she would be a good fit for the program, care providers came to pick her up.
She left the medical center still in withdrawal, anxious and doubtful about what would follow.
At the care center, Stephanie still feared that CPS would come seize her child – even though she was hesitant about parenting. The concern persisted: that at any moment, someone could walk in 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 lacked confidence at that point.”
Life on the streets, she said, was about getting by. Addiction came first; trust came last.
Stephanie had a single companion, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She was unable to care for herself, much less anyone else.
Daily, staff from Maddie’s Place drove her to a clinic for methadone, administered in pill form. Slowly, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with adverse reactions to milk and obvious stomach troubles. She needed dietary support. She also had sensory challenges and required an professional – all typical problems for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I could do this. I would become a mother.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a mentor, visited with her own five kids in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She holds a picture of the moment. She is wearing black pants and a hoodie, a beanie with a decoration on her head, resting on the floor with the exit nearby. She is lean. Her head is tilted forward so you miss her features. She is presenting her daughter on her lap for the young ones to see and they are crowding near, admiring and touching to the baby.
One child, eight, asked the mothers: “What about the fathers?” The parents responded that the men were occupied, engaged elsewhere, that they would be there if possible.
“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 made eye contact. “I broke down,” Stephanie said. “When a child recognized that infants need affection, then I could do this. I could parent.”
Methods to address drug-exposed newborns have been used for a long time.
The assessment tool was established in 1975|
