Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother visited the medical facility after a serious infection started to spread up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had assembled in a companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. The onset of withdrawal began. She bent over the bedside and became sick.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and take a hit.”
She had consumed opioids before arriving at the hospital and had sufficient opportunity to get treated before she had to return to use once more. She thought she still had a month remaining to plan her recovery and deliver her child.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was severe, but physicians found she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she walked out, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be switched to methadone, a drug that alleviates cravings and is commonly used in substance abuse treatment.
Five days later, on the 12th of November, Stephanie delivered a baby girl weighing 4lb 8oz – early, small but alive.
When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been given shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had sought recovery several times during pregnancy, and felt terrible each time she was unsuccessful. She felt worthless, berating herself for not being able to achieve the unattainable. An obstetrician told her to “simply” stop using. Even her supplier declined to supply to her when she became visibly pregnant.
“However, I failed,” she said. “I required assistance.”
The common assumption 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 overcome a chronic disease.
The newborn was transferred to the NICU. When Stephanie eventually visited her, she was connected to tubes and leads, so tiny she thought she would break her. Holding her for the first time, she felt nothing. “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 call her daughter after her caregiver, after the attendant who showed compassion to her.
Nurses and doctors told her about Maddie’s Place, a unique recovery environment where parents and infants affected by substance use are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with neonatal abstinence syndrome (NAS) regularly, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a small, growing network of centers like this facility is demonstrating a key fact: 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 finally did. After confirming she would be a good fit for the program, care providers came to bring her to the facility.
She departed the institution still in detox, scared and uncertain about what would follow.
At the care center, Stephanie still feared that CPS would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could arrive and separate them.
For the beginning period, Stephanie kept to herself. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about survival. Addiction came first; trust came last.
Stephanie had a single companion, but even that connection was tenuous. The those close to her always found ways to cause pain. She lacked the ability to care for herself, let alone anyone else.
Daily, staff from the facility transported her to a recovery program, administered in pill form. Slowly, she was starting to get clean.
She utilized each moment outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed feeding therapy. She also had increased sensitivity and required an professional – all typical problems for babies born with NAS.
Seeing that even a young person understands the need for care, then I could do this. I would become a mother.
On a day prior to the holiday, Stephanie remained in the shared space, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a peer support specialist, came over with her own family in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She keeps a photo of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, resting on the floor with the door behind her. She is lean. Her posture is humble so you do not see her expression. She is lifting the baby on her lap for the young ones to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the mothers: “Why are there no men?” The women attempted to clarify that the men were occupied, engaged elsewhere, that they would be there if possible.
“When I have kids,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I could do this. I would become a mother.”
Methods to address infants affected by substances have existed for decades.
The evaluation method was developed in 1975|
