Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Rescued Both Lives.
Eight months pregnant and in severe pain, a woman named Stephanie went to the medical facility after an infection began spreading up her legs. Without a job or home, estranged from her family, she lived in a shed she had built in a acquaintance's garden. She was also addicted to fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Withdrawal was setting in. She bent over the bedside and vomited.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had just enough time to get treated before she was compelled to leave to relapse. She thought she still had four weeks left to figure out how to get clean and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was serious, but medical staff detected she also had an ruptured membrane. The nurse, 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 withdrawal could endanger her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a drug that alleviates cravings and is commonly used in rehabilitation.
Five days later, on a day in November 2022, Stephanie gave birth to a infant weighing a small weight – early, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been administered a few hours prior to birth.
She felt unwell. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she relapsed. She felt hopeless, blaming herself for not being able to achieve the unattainable. An obstetrician told her to “just” stop using. Even her dealer would not provide to her when she became visibly pregnant.
“But I couldn’t,” she said. “I required assistance.”
The common assumption that her bond with her newborn would make her quit only led to increased guilt and negative self-talk, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could overcome a long-term illness.
The infant was moved to the special care nursery. When Stephanie at last met her, she was hooked up to monitors, so little she thought she would hurt her. Embracing her at last, she felt empty. “I gazed upon her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is found to have infant withdrawal condition regularly, infants are still rushed to special care and treated with pharmaceuticals while their mothers face child-protection investigations. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when parents and infants remain united, results get better, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength to call, but she eventually made the call. After ensuring she qualified for the program, care providers came to pick her up.
She departed the institution still in withdrawal, fearful and unsure about what would happen next.
At the care center, Stephanie still feared that CPS would come remove her daughter – even though she was not sure she wanted to keep her. The anxiety remained: that at any point, someone could walk in and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about survival. Drugs came first; trust came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to hurt her. She was unable to care for herself, not to mention anyone else.
Every day, staff from Maddie’s Place transported her to a recovery program, given as medication. Slowly, she was beginning recovery.
She spent every minute beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an occupational therapist – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I was capable. I could be a mom.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, visited with her own five kids in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She has an image of the moment. She is wearing casual attire, a cap with a pompom on her head, sitting on the wooden floor with the exit nearby. She is lean. Her posture is humble so you do not see her expression. She is lifting the baby on her knee for the children to see and they are gathered around, showing interest to the baby.
Jacob, eight, asked the moms: “What about the fathers?” The women attempted to clarify that the men were occupied, engaged elsewhere, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist made eye contact. “I became emotional,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I could parent.”
Methods to address babies with exposure have been used for a long time.
The evaluation method was created in 1975|
