Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the hospital emergency room after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had built in a companion's property. She was also hooked on fentanyl.
As medical staff managed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and vomited.
Stephanie eventually collapsed. “I need to leave. I have to go home and use drugs.”
She had taken the drug before arriving at the hospital and had sufficient opportunity to get treated before she needed to go home to get high again. She thought she still had a month remaining to figure out how to get clean and give birth.
The medical professional intervened. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was critical, but doctors had discovered 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 at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be switched to methadone, a drug that alleviates cravings and is commonly used in substance abuse treatment.
After five days, on 12 November 2022, Stephanie delivered a infant weighing a small weight – early, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her epidural had failed, her last dose of fentanyl had been provided a few hours prior to birth.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she relapsed. She felt without value, criticizing herself for not being able to achieve the unattainable. An OBGYN told her to “only” stop using. Even her source declined to supply to her when she became obviously with child.
“Yet I was unable,” she said. “I required assistance.”
The widespread belief that her love for her baby would make her quit only led to increased guilt and self-harm, a impetus for her to return to drugs. Yet she could not simply will her addiction away, any more than she could will away a long-term illness.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was attached to tubes and leads, so small she thought she would break her. Embracing her at last, she felt detached. “I gazed upon her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to call her daughter the same as her nurse, after the nurse who had been so kind to her.
Hospital staff told her about a care center, a innovative treatment home where parents and infants affected by substance use are treated together, not apart.
In numerous states, where a baby is identified with newborn addiction symptoms every 18 minutes, infants are still quickly moved to hospitals and medicated while their mothers face child-protection investigations. But a small, growing network of centers like this facility is demonstrating a key fact: when families are kept intact, outcomes improve, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, a couple of employees came to collect her.
She departed the institution still in withdrawal, fearful and unsure about what would happen next.
At Maddie’s Place, Stephanie still feared that CPS would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any time, someone could walk in and remove her child.
For the beginning period, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” 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; trust came last.
Stephanie had a trusted ally, but even that connection was tenuous. The those close to her always found ways to hurt her. She did not know how to value herself, much less anyone else.
Daily, staff from the facility took her to a treatment center, given as medication. Slowly, she was starting to get clean.
She utilized each moment beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with intolerance to some formulas and obvious stomach troubles. She needed nutritional guidance. She also had increased sensitivity and required an occupational therapist – all common issues 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.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, visited with her own five kids in tow to deliver baked goods. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in wonder of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in casual attire, a beanie with a bobble on her head, seated on the ground with the door behind her. She is slender. Her head is tilted forward so you miss her features. She is presenting her daughter on her knee for the children to see and they are crowding near, showing interest to the baby.
Jacob, eight, asked the parents: “Where are all the dads?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if they could.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I became emotional,” Stephanie said. “If this little kid could see that newborns require care, then I could do this. I could be a mom.”
Tools for treating infants affected by substances have existed for decades.
The Finnegan NAS scale was developed in 1975|
