Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother went to the ER after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she resided in a small structure she had assembled in a acquaintance's garden. She was also hooked on fentanyl.
As physicians addressed her infection, she began to panic. Symptoms of withdrawal emerged. She slumped forward and vomited.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and take a hit.”
She had used fentanyl before coming to the ER and had only a brief window to get treated before she needed to go home to use once more. She thought she still had several weeks to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a treatment that reduces symptoms and is commonly used in substance abuse treatment.
Five days later, on a day in November 2022, Stephanie delivered a baby girl weighing 4lb 8oz – early, small but alive.
When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her pain relief did not work, her final administration of fentanyl had been provided a few hours prior to birth.
She felt unwell. Not ready for motherhood. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt terrible each time she was unsuccessful. She felt without value, blaming herself for not being able to overcome the challenge. An doctor told her to “only” stop using. Even her supplier refused to sell to her when she became visibly pregnant.
“But I couldn’t,” she said. “I required assistance.”
The widespread belief that her affection for her child would make her quit only led to greater shame and negative self-talk, a impetus for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.
The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was connected to medical equipment, so tiny she thought she would harm her. Holding her for the first time, she felt empty. “I gazed upon her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to name her baby after her caregiver, after the nurse who had been so kind to her.
Hospital staff told her about Maddie’s Place, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is found to have newborn addiction symptoms every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face child-protection investigations. But a developing system of centers like the care home is proving a simple point: when families are kept intact, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie a period to find strength to call, but she finally did. After verifying her eligibility for the program, a couple of employees came to pick her up.
She left the medical center still in detox, fearful and unsure about what would follow.
At the facility, Stephanie still was concerned that child services would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any time, someone could enter and take her baby away.
For the beginning period, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about enduring. Drugs came first; reliance came last.
Stephanie had one close friend, but even that bond was fragile. The people she loved always found ways to cause pain. She lacked the ability to love herself, not to mention anyone else.
Each day, staff from Maddie’s Place transported her to a clinic for methadone, administered in pill form. Slowly, she was beginning recovery.
She utilized each moment when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and severe digestive problems. She needed feeding therapy. She also had heightened sensory issues and required an professional – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I was capable. I could parent.
On a day prior to the holiday, Stephanie was in the common room, where parents in active addiction can come for monitored interactions with their babies. Katie Bunch-Smith, a mentor, came over with her own five kids in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The young ones stared in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She has an image of the moment. She is dressed in black pants and a hoodie, a gray knit hat with a bobble on her head, seated on the ground with the exit nearby. She is lean. Her posture is humble so you cannot see her face. She is lifting the baby on her knee for the children to see and they are standing close, showing interest to the baby.
One child, eight, asked the moms: “Why are there no men?” The women attempted to clarify that the fathers had obligations, handling responsibilities, that they would be there if possible.
“In the future,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that newborns require care, then I could do this. I could be a mom.”
Methods to address drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was created in 1975|
