Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the hospital emergency room after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she resided in a small structure she had built in a companion's property. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. The onset of withdrawal began. She slumped forward and threw up.
Stephanie eventually collapsed. “I need to leave. I have to go home and use drugs.”
She had consumed opioids before seeking medical help and had just enough time to get treated before she had to return to relapse. She thought she still had a month remaining to plan her recovery and have this baby.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was severe, 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 be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that symptoms could threaten 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 12 November 2022, Stephanie delivered a infant weighing 4lb 8oz – early, little but surviving.
When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been provided shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she was unsuccessful. She felt hopeless, blaming herself for not being able to do the impossible. An obstetrician told her to “just” stop using. Even her dealer would not provide to her when she became clearly expecting.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her quit only led to greater shame and self-abuse, a cause for her to return to drugs. Yet she could not simply will her addiction away, any more than she could overcome a chronic disease.
The newborn was transferred to the neonatal intensive care unit. When Stephanie at last met her, she was hooked up to medical equipment, so tiny she thought she would hurt her. Cradling her initially, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to name her baby Izzie, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are cared for jointly, not apart.
In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs and medicated while their mothers face custody evaluations. But a limited but expanding group of centers like this facility is proving a simple point: when parents and infants remain united, recovery succeeds, fewer children enter care and future expenses reduce.
It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, two staff members came to bring her to the facility.
She stepped out of the hospital still in detox, anxious and doubtful 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 fear lingered: that at any moment, someone could arrive and separate them.
For the first two weeks, Stephanie stayed withdrawn. “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 bond was fragile. The individuals she cared for always found ways to cause pain. She was unable to care for herself, not to mention anyone else.
Each day, staff from the facility transported her to a recovery program, provided orally. Slowly, she was embracing sobriety.
She utilized each moment when not in sessions with Izzie, and could see that her baby was getting the specialized care 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 sensory challenges and required an occupational therapist – all common issues for babies affected by withdrawal.
When a child recognizes these infants need affection, then I was capable. I could parent.
During a pre-holiday visit, Stephanie was in the common room, where individuals struggling with substance use can come for monitored interactions with their babies. An advocate, a peer support specialist, stopped by with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She has an image of the moment. She is wearing casual attire, a cap with a pompom on her head, sitting on the wooden floor with the door behind her. She is thin. Her posture is humble so you cannot see her face. She is lifting the baby on her leg for the children to see and they are gathered around, showing interest to the baby.
Jacob, eight, asked the moms: “Why are there no men?” The moms tried to explain that the men were occupied, engaged elsewhere, that they would be there if possible.
“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 the specialist looked at each other. “I became emotional,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.”
Approaches for managing infants affected by substances have existed for decades.
The evaluation method was developed in 1975|
