Fentanyl Addiction During Pregnancy: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the ER after a serious infection started to spread up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had constructed in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and vomited.
Stephanie finally broke down. “I have to get out of here. I have to go home and take a hit.”
She had consumed opioids before seeking medical help and had only a brief window to get treated before she had to return to relapse. She thought she still had four weeks left to figure out how to get clean and give birth.
The medical professional intervened. 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 critical, but physicians found she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.
A short time later, on the 12th of November, Stephanie had a infant weighing 4lb 8oz – born before term, small but alive.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her anesthesia was ineffective, her final administration of fentanyl had been administered four hours before delivery.
She felt sick. Unprepared to be a mother. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she relapsed. She felt hopeless, blaming herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her source would not provide to her when she became clearly expecting.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her recover only led to greater shame and self-abuse, a impetus for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to tubes and leads, so little she thought she would break her. Embracing her at last, 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.
Following a brief period she decided to call her daughter after her caregiver, after the professional who provided support to her.
Medical personnel told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In many parts of America, where a baby is identified with infant withdrawal condition frequently, infants are still rushed to special care and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like this facility is proving a simple point: when mothers and babies stay together, results get better, fewer children enter care and long-term costs decline.
It took Stephanie a period to find strength to call, but she eventually made the call. After confirming she would be a good fit for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in recovery, scared and uncertain about what would come next.
At Maddie’s Place, Stephanie still worried that authorities would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could enter and remove her child.
For the initial fortnight, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about survival. Addiction came first; reliance came last.
Stephanie had a single companion, but even that relationship was delicate. The people she loved always found ways to cause pain. She did not know how to value herself, let alone anyone else.
Daily, staff from Maddie’s Place took her to a recovery program, given as medication. Over time, she was beginning recovery.
She utilized each moment outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and severe digestive problems. She needed nutritional guidance. 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 parent.
During a pre-holiday visit, Stephanie was in the common room, where parents in active addiction can come for monitored interactions with their babies. A support specialist, a mentor, visited with her own five kids in tow to bring treats. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the tiny infant in Stephanie’s arms. “They were innocent,” 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 beanie with a decoration on her head, sitting on the wooden floor with the exit nearby. She is lean. Her face is downcast so you miss her features. She is lifting the baby on her leg for the young ones to see and they are crowding near, showing interest to the baby.
One child, eight, asked the mothers: “What about the fathers?” The parents responded that the fathers had obligations, engaged elsewhere, that they would be there if they could.
“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 Bunch-Smith made eye contact. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I could do this. I could parent.”
Methods to address infants affected by substances have existed for decades.
The assessment tool was established in 1975|
