Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Transformed Their Futures.
Eight months pregnant and in severe pain, the expectant mother went to the medical facility after her infection worsened up her legs. Without a job or home, separated from loved ones, she lived in a shed she had built in a friend’s yard. She was also addicted to fentanyl.
As doctors treated her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie eventually collapsed. “I need to leave. I have to go home and take a hit.”
She had consumed opioids before seeking medical help and had only a brief window to get treated before she needed to go home to relapse. 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 staying put.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was critical, but doctors had discovered she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a drug that alleviates cravings and is often prescribed in rehabilitation.
After five days, on the 12th of November, Stephanie gave birth to a infant weighing just over four pounds – early, tiny yet healthy.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her epidural had failed, her last dose of fentanyl had been given shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety several times during pregnancy, and felt terrible each time she relapsed. She felt without value, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “only” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“However, I failed,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her quit only led to deeper self-loathing and self-abuse, a impetus for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a long-term illness.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was attached to monitors, so little she thought she would break her. Cradling her initially, she felt empty. “I looked at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to give her child the name the same as her nurse, after the nurse who had been so kind to her.
Hospital staff told her about a specialized facility, a innovative treatment home where women and their babies are supported as a unit, not apart.
In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) frequently, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a developing system of centers like the care home is demonstrating a key fact: when parents and infants remain united, results get better, foster placements fall and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After verifying her eligibility for the program, a couple of employees came to bring her to the facility.
She left the medical center still in recovery, fearful and unsure about what would happen next.
At Maddie’s Place, Stephanie still feared that child services would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could enter and separate them.
For the first two weeks, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Drugs came first; trust came last.
Stephanie had a trusted ally, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She was unable to value herself, much less anyone else.
Each day, staff from the facility took her to a recovery program, given as medication. Slowly, she was embracing sobriety.
She devoted all her time outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and severe digestive problems. She needed nutritional guidance. She also had sensory challenges and required an specialist – all frequent conditions for babies affected by withdrawal.
When a child recognizes these infants need affection, then I found the strength. I could parent.
On a day prior to the holiday, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a peer support specialist, visited with her own family in tow to drop off cookies. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in wonder 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 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 slender. Her face is downcast so you miss her features. She is lifting the baby on her leg for the children to see and they are crowding near, showing interest to the baby.
One child, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if possible.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and her companion exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I could do this. I could be a mom.”
Tools for treating babies with exposure have existed for decades.
The Finnegan NAS scale was created in 1975|
