Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the ER after an infection began spreading up her legs. Unemployed and homeless, separated from loved ones, she stayed in a makeshift shelter she had built in a acquaintance's garden. She was also hooked on fentanyl.
As physicians addressed her infection, she began to panic. The onset of withdrawal began. She leaned over the bed and became sick.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and get high.”
She had taken the drug before seeking medical help and had sufficient opportunity to get treated before she had to return to use once more. She thought she still had several weeks to figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was severe, but medical staff detected she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she left, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be placed on methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.
After five days, on the 12th of November, Stephanie delivered a daughter weighing a small weight – premature, small but alive.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “not now.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been administered a few hours prior to birth.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she relapsed. She felt worthless, berating herself for not being able to achieve the unattainable. An OBGYN told her to “just” stop using. Even her supplier declined to supply to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her love for her baby would make her stop using only led to increased guilt and negative self-talk, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.
The infant was moved to the special care nursery. When Stephanie at last met her, she was attached to tubes and leads, so little she thought she would break her. Embracing her at last, she felt detached. “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 Izzie, after the nurse who had been so kind to her.
Nurses and doctors told her about a specialized facility, a innovative treatment home where women and their babies are treated together, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition frequently, infants are still quickly moved to hospitals and medicated while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when mothers and babies stay together, results get better, foster placements fall 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 pick her up.
She stepped out of the hospital still in withdrawal, anxious and doubtful about what would happen next.
At the care center, Stephanie still was concerned that child services would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any point, someone could arrive and remove her child.
For the initial fortnight, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about survival. Substances came first; faith came last.
Stephanie had a single companion, but even that connection was tenuous. The individuals she cared for always found ways to let her down. She lacked the ability to care for herself, not to mention anyone else.
Each day, staff from the center transported her to a recovery program, given as medication. Gradually, she was starting to get clean.
She spent every minute outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with intolerance to some formulas and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an professional – 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 could be a mom.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where parents in active addiction can come for monitored interactions with their babies. A support specialist, a recovery coach, visited with her own five kids in tow to drop off cookies. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She keeps a photo of the moment. She is dressed in casual attire, a gray knit hat with a pompom on her head, seated on the ground with the entryway at her back. She is lean. Her posture is humble so you miss her features. She is lifting the baby on her lap for the other kids to see and they are crowding near, fawning and reaching out to the baby.
Jacob, eight, asked the parents: “What about the fathers?” The parents responded that the men were occupied, called away to other tasks, that they would be there if possible.
“In the future,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith looked at each other. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I could do this. I could parent.”
Tools for treating drug-exposed newborns have been available for years.
The Finnegan NAS scale was developed in 1975|
