Fentanyl Addiction During Pregnancy: Choosing Motherhood Transformed Their Futures.
Eight months pregnant and in severe pain, the expectant mother visited the medical facility after a serious infection started to spread up her legs. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had constructed in a acquaintance's garden. She was also addicted to fentanyl.
As medical staff managed her infection, she started to feel anxious. The onset of withdrawal began. She slumped forward and vomited.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before seeking medical help and had only a brief window 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 give birth.
The medical professional intervened. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a medication that eases withdrawal and is frequently utilized in addiction recovery.
Five days later, on the 12th of November, Stephanie delivered a daughter weighing 4lb 8oz – premature, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “no.” She was detached. Her epidural had failed, her last dose of fentanyl had been administered a few hours prior to birth.
She felt ill. Not ready for motherhood. Not fit.
Stephanie had attempted sobriety repeatedly before birth, and felt horrible each time she failed. She felt without value, berating herself for not being able to do the impossible. An obstetrician told her to “only” stop using. Even her dealer would not provide to her when she became clearly expecting.
“Yet I was unable,” she said. “I needed help.”
The widespread belief that her love for her baby would make her stop using only led to greater shame and self-abuse, a trigger for her to return to drugs. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The infant was moved to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to medical equipment, so small she thought she would break her. Holding her for the first time, she felt nothing. “I just stared at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Two days later she decided to name her baby Izzie, after the attendant who showed compassion to her.
Medical personnel told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is identified with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still whisked to NICUs and medicated while their mothers face child-protection investigations. But a limited but expanding group of centers like this facility is showing an important truth: when mothers and babies stay together, recovery succeeds, foster placements fall and overall savings increase.
It took Stephanie a period to find strength to call, but she ultimately reached out. After confirming she would be a good fit for the program, care providers came to bring her to the facility.
She departed the institution still in detox, fearful and unsure about what would happen next.
At the care center, Stephanie still worried that authorities would come remove her daughter – even though she was uncertain about motherhood. The concern persisted: that at any point, someone could walk in and separate them.
For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about getting by. Substances came first; faith came last.
Stephanie had a trusted ally, but even that relationship was delicate. The people she loved always found ways to cause pain. She lacked the ability to value herself, not to mention anyone else.
Each day, staff from Maddie’s Place took her to a recovery program, given as medication. Slowly, she was starting to get clean.
She utilized each moment outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had increased sensitivity and required an occupational therapist – all common issues for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I was capable. I could parent.
On a day prior to the holiday, Stephanie remained in the shared space, where parents in active addiction can come for monitored interactions with their babies. A support specialist, a mentor, came over with her own family in tow to drop off cookies. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in awe of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in black pants and a hoodie, a cap with a bobble on her head, seated on the ground with the entryway at her back. She is thin. Her posture is humble so you miss her features. She is lifting the baby on her knee for the children to see and they are crowding near, admiring and touching to the baby.
A young boy, eight, asked the moms: “Where are all the dads?” The moms tried to explain that the men were occupied, 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 broke down,” Stephanie said. “If this little kid could see that infants need affection, then I could do this. I would become a mother.”
Methods to address babies with exposure have existed for decades.
The evaluation method was established in 1975|
