Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie visited the hospital emergency room after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she stayed in a makeshift shelter she had built in a companion's property. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. Symptoms of withdrawal emerged. She slumped forward and became sick.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”
She had taken the drug before coming to the ER and had just enough time to get treated before she was compelled to leave to relapse. She thought she still had a month remaining to plan her recovery and have this baby.
The attending nurse disagreed. 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 critical, but medical staff detected she also had an ruptured membrane. The nurse, Izzie, warned her: if she walked out, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in rehabilitation.
After five days, on the 12th of November, Stephanie gave birth to a infant weighing just over four pounds – born before term, tiny yet healthy.
When the nurse asked if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her pain relief did not work, her previous intake of fentanyl had been provided a few hours prior to birth.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt awful each time she failed. She felt hopeless, berating herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her source refused to sell to her when she became visibly pregnant.
“However, I failed,” she said. “I required assistance.”
The common assumption that her affection for her child would make her stop using only led to increased guilt and negative self-talk, a impetus for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The infant was moved to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to medical equipment, so small she thought she would harm her. Holding her for the first time, she felt detached. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
After two days she decided to call her daughter Izzie, after the nurse who had been so kind to her.
Medical personnel told her about Maddie’s Place, a unique recovery environment where parents and infants affected by substance use are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is showing an important truth: when families are kept intact, recovery succeeds, 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 bring her to the facility.
She stepped out of the hospital still in detox, fearful and unsure about what would follow.
At the facility, Stephanie still feared that CPS would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any moment, someone could walk in and separate them.
For the first two weeks, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Drugs came first; faith came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to cause pain. She was unable to care for herself, much less anyone else.
Every day, staff from Maddie’s Place took her to a clinic for methadone, given as medication. Gradually, she was embracing sobriety.
She devoted all her time when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed nutritional guidance. She also had increased sensitivity and required an specialist – all frequent conditions for babies affected by withdrawal.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
During a pre-holiday visit, Stephanie remained in the shared space, where parents in active addiction can come for monitored interactions with their babies. An advocate, a recovery coach, came over with her own children in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She holds a picture of the moment. She is clad in casual attire, a gray knit hat with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her head is tilted forward so you cannot see her face. She is holding Izzie up on her lap for the young ones to see and they are crowding near, admiring and touching to the baby.
Jacob, eight, asked the parents: “Where are all the dads?” The parents responded that the fathers had obligations, handling responsibilities, that they would be there given the chance.
“In the future,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that infants need affection, 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|
