Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother visited the medical facility after an infection began spreading up her legs. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had assembled in a acquaintance's garden. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. Withdrawal was setting in. 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 taken the drug before arriving at the hospital and had sufficient opportunity to get treated before she had to return to get high again. She thought she still had four weeks left to find a way to become sober and give birth.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was critical, 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.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl periodically, 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 often prescribed in addiction recovery.
Five days later, on 12 November 2022, Stephanie had a infant weighing a small weight – early, small but alive.
When the nurse asked if she wanted to hold her baby, Stephanie said “I cannot.” She was detached. Her epidural had failed, her previous intake of fentanyl had been administered a few hours prior to birth.
She felt ill. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety several times during pregnancy, and felt awful each time she relapsed. She felt hopeless, blaming herself for not being able to achieve the unattainable. An doctor told her to “just” stop using. Even her source would not provide to her when she became visibly pregnant.
“Yet I was unable,” she said. “I required assistance.”
The widespread belief that her affection for her child would make her recover only led to increased guilt and negative self-talk, a cause for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to monitors, so tiny she thought she would harm her. Cradling her initially, she felt empty. “I gazed upon her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to give her child the name after her caregiver, after the professional who provided support to her.
Nurses and doctors told her about Maddie’s Place, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In many parts of America, where a baby is identified with infant withdrawal condition every 18 minutes, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a developing system 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 future expenses reduce.
It took Stephanie a period to find strength to call, but she finally did. After confirming she would be a good fit for the program, a couple of employees came to bring her to the facility.
She stepped out of the hospital still in detox, scared and uncertain about what would follow.
At the facility, Stephanie still worried that CPS would come remove her daughter – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could arrive and separate them.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Addiction came first; trust came last.
Stephanie had a trusted ally, but even that relationship was delicate. The people she loved always found ways to hurt her. She did not know how to care for herself, much less anyone else.
Daily, staff from the center drove her to a recovery program, administered in pill form. Gradually, she was embracing sobriety.
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 adverse reactions to milk and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an specialist – all typical problems for babies born with NAS.
Seeing that even a young person understands the need for care, then I found the strength. I could be a mom.
One afternoon before Thanksgiving, Stephanie was in the common room, where parents in active addiction can come for guided meetings with their babies. A support specialist, a recovery coach, visited with her own family in tow to bring treats. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She holds a picture of the moment. She is dressed in dark trousers and a sweatshirt, 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 knee for the young ones to see and they are gathered around, admiring and touching to the baby.
Jacob, eight, asked the mothers: “Where are all the dads?” The parents responded that the fathers had obligations, engaged elsewhere, that they would be there if they could.
“When I have kids,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and Bunch-Smith exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I found the courage. I could parent.”
Methods to address drug-exposed newborns have been available for years.
The assessment tool was created in 1975|
