Fentanyl Addiction During Pregnancy: Choosing Motherhood Transformed Their Futures.
Eight months pregnant and in severe pain, 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 built in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and became sick.
Stephanie ultimately gave in. “I need to leave. I have to go home and take a hit.”
She had taken the drug before arriving at the hospital and had only a brief window 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 deliver her child.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the leg infection was critical, but physicians found she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is commonly used in rehabilitation.
A short time later, on the 12th of November, Stephanie gave birth to a daughter weighing 4lb 8oz – early, tiny yet healthy.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been provided a few hours prior to birth.
She felt ill. Not ready for motherhood. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt horrible each time she relapsed. She felt hopeless, berating herself for not being able to overcome the challenge. An OBGYN told her to “simply” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“But I couldn’t,” she said. “I required assistance.”
The pervasive expectation that her affection for her child would make her quit only led to deeper self-loathing and self-harm, a cause for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a long-term illness.
The infant was moved to the special care nursery. When Stephanie eventually visited her, she was connected to monitors, so tiny she thought she would harm her. Holding her for the first time, she felt detached. “I looked at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
After two days she decided to give her child the name Izzie, after the attendant who showed compassion to her.
Medical personnel told her about a specialized facility, a innovative treatment home where parents and infants affected by substance use are treated together, not apart.
In many parts of America, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a developing system of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, outcomes improve, fewer children enter care and future expenses reduce.
It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, a couple of employees came to bring her to the facility.
She departed the institution still in withdrawal, scared and uncertain about what would follow.
At the care center, Stephanie still was concerned that child services would come remove her daughter – even though she was not sure she wanted to keep her. The fear lingered: that at any moment, someone could arrive and remove her child.
For the first two weeks, Stephanie kept to herself. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about enduring. Addiction came first; faith came last.
Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to hurt her. She did not know how to care for herself, much less anyone else.
Daily, staff from the center took her to a recovery program, provided orally. Slowly, she was beginning recovery.
She utilized each moment outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed dietary support. She also had heightened sensory issues and required an specialist – all frequent conditions for babies born with NAS.
Seeing that even a young person understands the need for care, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where individuals struggling with substance use can come for monitored interactions with their babies. A support specialist, a mentor, visited with her own five kids in tow to deliver baked goods. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She has an image of the moment. She is clad in dark trousers and a sweatshirt, a cap with a decoration on her head, seated on the ground with the exit nearby. She is slender. Her posture is humble so you cannot see her face. She is holding Izzie up on her lap for the children to see and they are crowding near, showing interest to the baby.
A young boy, eight, asked the parents: “What about the fathers?” The parents responded that the men were occupied, handling responsibilities, that they would be there given the chance.
“When I have kids,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and her companion made eye contact. “I broke down,” Stephanie said. “If this little kid could see that infants need affection, then I found the courage. I could be a mom.”
Methods to address babies with exposure have been available for years.
The evaluation method was established in 1975|
