Fentanyl Addiction During Pregnancy: How Keeping Her Baby Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother arrived at the hospital emergency room after an infection began spreading up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had built in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and threw up.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and take a hit.”
She had used fentanyl before coming to the ER and had just enough time to get treated before she had to return to use once more. She thought she still had four weeks left to figure out how to get clean and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was critical, but medical staff detected she also had an ruptured membrane. The nurse, her nurse, warned her: if she departed, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be placed on 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 a small weight – premature, tiny yet healthy.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was detached. Her pain relief did not work, her last dose of fentanyl had been administered four hours before delivery.
She felt ill. Not ready for motherhood. Undeserving.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she relapsed. She felt worthless, criticizing herself for not being able to achieve the unattainable. An doctor told her to “just” stop using. Even her source refused to sell to her when she became visibly pregnant.
“However, I failed,” she said. “I required assistance.”
The pervasive expectation that her love for her baby would make her quit only led to greater shame and self-harm, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could will away a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to tubes and leads, so tiny she thought she would hurt her. Embracing her at last, she felt detached. “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.
Following a brief period she decided to call her daughter Izzie, after the nurse who had been so kind to her.
Hospital staff told her about a care center, a innovative treatment home where parents and infants affected by substance use are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition regularly, infants are still rushed to special care and treated with pharmaceuticals while their mothers face custody evaluations. But a limited but expanding group of centers like the care home is demonstrating a key fact: when mothers and babies stay together, results get better, fewer children enter care and overall savings increase.
It took Stephanie a period to find strength to call, but she ultimately reached out. After verifying her eligibility for the program, a couple of employees came to collect her.
She departed the institution still in withdrawal, scared and uncertain about what would follow.
At Maddie’s Place, Stephanie still feared that authorities would come take Izzie – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could walk in and take her baby away.
For the first two weeks, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I was suspicious at that point.”
Homelessness, she said, was about enduring. Drugs came first; faith came last.
Stephanie had one close friend, but even that relationship was delicate. The those close to her always found ways to hurt her. She was unable to value herself, let alone anyone else.
Each day, staff from the facility drove her to a clinic for methadone, given as medication. Slowly, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with adverse reactions to milk and obvious stomach troubles. She needed nutritional guidance. She also had heightened sensory issues and required an specialist – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I found the strength. I would become a mother.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for supervised visits with their babies. A support specialist, a mentor, visited with her own family in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in awe of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She holds a picture of the moment. She is dressed in casual attire, a beanie with a bobble on her head, resting on the floor with the exit nearby. She is lean. Her face is downcast so you cannot see her face. She is holding Izzie up on her leg for the children to see and they are gathered around, admiring and touching to the baby.
Jacob, eight, asked the moms: “What about the fathers?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if possible.
“When I have kids,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and Bunch-Smith made eye contact. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I was able. I could parent.”
Tools for treating infants affected by substances have been used for a long time.
The assessment tool was developed in 1975|
