Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother went to the medical facility after her infection worsened up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had assembled in a companion's property. She was also addicted to fentanyl.
As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had used fentanyl before arriving at the hospital and had sufficient opportunity to get treated before she was compelled to leave to use once more. She thought she still had several weeks to find a way to become sober and deliver her child.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was critical, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.
A short time later, on 12 November 2022, Stephanie delivered a infant weighing 4lb 8oz – born before term, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her epidural had failed, her last dose of fentanyl had been provided shortly before she gave birth.
She felt unwell. Not ready for motherhood. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she was unsuccessful. She felt worthless, blaming herself for not being able to achieve the unattainable. An OBGYN told her to “simply” stop using. Even her source refused to sell to her when she became visibly pregnant.
“Yet I was unable,” she said. “I required assistance.”
The pervasive expectation that her bond with her newborn would make her quit only led to deeper self-loathing and self-harm, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The infant was moved to the special care nursery. When Stephanie at last met her, she was attached to medical equipment, so small she thought she would break 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 still wasn’t sure she wanted to be her mother.
Two days later she decided to name her baby after her caregiver, after the professional who provided support to her.
Medical personnel told her about a specialized facility, a unique recovery environment where mothers and their drug-exposed newborns are cared for jointly, not apart.
In much of the US, where a baby is identified with infant withdrawal condition regularly, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a developing system of centers like the care home is demonstrating a key fact: when parents and infants remain united, outcomes improve, custody cases decrease and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After verifying her eligibility for the program, care providers came to pick her up.
She stepped out of the hospital still in withdrawal, fearful and unsure about what would happen next.
At the care center, Stephanie still worried that CPS would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any point, someone could enter and take her baby away.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about survival. Substances came first; faith came last.
Stephanie had a single companion, but even that relationship was delicate. The those close to her always found ways to let her down. She lacked the ability to love herself, not to mention anyone else.
Every day, staff from Maddie’s Place drove her to a recovery program, administered in pill form. Over time, she was starting to get clean.
She utilized each moment outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had increased sensitivity and required an occupational therapist – all typical problems for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I was capable. I could be a mom.
During a pre-holiday visit, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a mentor, visited with her own five kids in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in wonder of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She has an image of the moment. She is dressed in dark trousers and a sweatshirt, a cap with a pompom on her head, seated on the ground with the entryway at her back. She is slender. Her posture is humble so you do not see her expression. She is holding Izzie up on her knee for the children to see and they are standing close, admiring and touching to the baby.
One child, eight, asked the mothers: “Where are all the dads?” The parents responded that the fathers had obligations, handling responsibilities, 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 her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I could be a mom.”
Methods to address drug-exposed newborns have existed for decades.
The Finnegan NAS scale was established in 1975|
