Fentanyl Addiction During Pregnancy: How Keeping Her Baby Rescued Both Lives.
Eight months pregnant and in severe pain, the expectant mother visited the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, estranged from her family, she resided in a small structure she had constructed in a companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and became sick.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before arriving at the hospital and had sufficient opportunity to get treated before she was compelled to leave to get high again. She thought she still had four weeks left to figure out how to get clean and have this baby.
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 leg infection was severe, but physicians found she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she left, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
Five days later, on a day in November 2022, Stephanie gave birth to a baby girl weighing a small weight – early, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her final administration of fentanyl had been given shortly before she gave birth.
She felt sick. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt horrible each time she relapsed. She felt without value, criticizing herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her stop using only led to greater shame and negative self-talk, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The newborn was transferred to the NICU. When Stephanie finally saw her her, she was connected to tubes and leads, so tiny she thought she would harm her. Holding her for the first time, she felt empty. “I just stared at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to give her child the name the same as her nurse, after the professional who provided support to her.
Nurses and doctors told her about a specialized facility, a new kind of care center where women and their babies are supported as a unit, not apart.
In many parts of America, where a baby is found to have neonatal abstinence syndrome (NAS) every 18 minutes, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face parental assessments. But a limited but expanding group of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, results get better, custody cases decrease and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility for the program, two staff members came to collect her.
She departed the institution still in detox, anxious and doubtful about what would happen next.
At the care center, Stephanie still feared that authorities would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could walk in and take her baby away.
For the initial fortnight, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about enduring. Drugs came first; faith came last.
Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to cause pain. She lacked the ability to care for herself, much less anyone else.
Daily, staff from the facility drove her to a treatment center, provided orally. Slowly, she was beginning recovery.
She devoted all her time outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had heightened sensory issues and required an specialist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I could do this. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a mentor, visited with her own family in tow to bring treats. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in awe of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She keeps a photo of the moment. She is clad in black pants and a hoodie, a beanie with a bobble on her head, resting on the floor with the entryway at her back. She is lean. Her head is tilted forward so you cannot see her face. She is presenting her daughter on her leg for the children to see and they are gathered around, fawning and reaching out to the baby.
One child, eight, asked the mothers: “Where are all the dads?” The moms tried to explain that the men were occupied, called away to other tasks, that they would be there if they could.
“In the future,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “When a child recognized that infants need affection, then I was able. I would become a mother.”
Tools for treating babies with exposure have been used for a long time.
The evaluation method was created in 1975|
