Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Saved Them Both.
In her eighth month of pregnancy and suffering, the expectant mother went to the ER after an infection began spreading up her legs. Without a job or home, estranged from her family, she lived in a shed she had constructed in a companion's property. She was also addicted to fentanyl.
As physicians addressed her infection, she started to feel anxious. Withdrawal was setting in. She slumped forward and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had used fentanyl before seeking medical help and had sufficient opportunity to get treated before she needed to go home to relapse. She thought she still had four weeks left to find a way to become sober and have this baby.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was serious, but physicians found she also had an ruptured membrane. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is commonly used in addiction recovery.
A short time later, on the 12th of November, Stephanie had a infant weighing just over four pounds – early, small but alive.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her anesthesia was ineffective, her last dose of fentanyl had been given four hours before delivery.
She felt ill. Unprepared to be a mother. Undeserving.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she failed. She felt without value, blaming herself for not being able to achieve the unattainable. An doctor told her to “just” stop using. Even her source declined to supply to her when she became visibly pregnant.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her affection for her child would make her quit only led to greater shame and negative self-talk, a impetus for her to use again. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the neonatal intensive care unit. When Stephanie at last met her, she was connected to monitors, so little she thought she would break her. Cradling her initially, she felt nothing. “I just stared at 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 give her child the name after her caregiver, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a new kind of care center 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 rushed to special care and given drugs while their mothers face custody evaluations. But a developing system of centers like Maddie’s Place is showing an important truth: when parents and infants remain united, results get better, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After confirming she would be a good fit for the program, a couple of employees came to bring her to the facility.
She departed the institution still in detox, scared and uncertain about what would follow.
At the facility, Stephanie still was concerned that child services 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 separate them.
For the beginning period, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Addiction came first; reliance came last.
Stephanie had a trusted ally, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She lacked the ability to value herself, let alone anyone else.
Each day, staff from Maddie’s Place took her to a recovery program, given as medication. Over time, she was starting to get clean.
She spent every minute outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an specialist – all typical problems for babies affected by withdrawal.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where those still using can come for supervised visits with their babies. A support specialist, a peer support specialist, stopped by with her own five kids in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in admiration of the little newborn in Stephanie’s arms. “They had no care in the world,” 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 decoration on her head, seated on the ground with the entryway at her back. She is lean. Her head is tilted forward so you do not see her expression. She is lifting the baby on her knee for the other kids to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the mothers: “Where are all the dads?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if they could.
“When I have kids,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I found the courage. I could parent.”
Approaches for managing infants affected by substances have existed for decades.
The evaluation method was created in 1975|
