Fentanyl Addiction During Pregnancy: How Keeping Her Baby Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother arrived at the medical facility after a serious infection started to spread up her legs. Without a job or home, separated from loved ones, 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 grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and became sick.
Stephanie ultimately gave in. “Listen, I gotta go. 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 had to return 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 not going anywhere.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was critical, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she walked out, she and her baby would not survive.
She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie delivered a baby girl weighing just over four pounds – premature, small but alive.
When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been administered a few hours prior to birth.
She felt sick. Not ready for motherhood. Undeserving.
Stephanie had tried to get clean repeatedly before birth, and felt awful each time she relapsed. She felt without value, criticizing herself for not being able to achieve the unattainable. An obstetrician told her to “simply” stop using. Even her supplier would not provide to her when she became clearly expecting.
“Yet I was unable,” she said. “I needed help.”
The pervasive expectation that her bond with her newborn would make her quit only led to increased guilt and negative self-talk, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could overcome a long-term illness.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was connected to tubes and leads, so little she thought she would break her. Holding her for the first time, she felt detached. “I just stared at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to give her child the name the same as her nurse, after the professional who provided support to her.
Nurses and doctors told her about Maddie’s Place, a new kind of care center where mothers and their drug-exposed newborns are cared for jointly, not apart.
In much of the US, where a baby is found to have neonatal abstinence syndrome (NAS) 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 the care home is proving a simple point: when mothers and babies stay together, recovery succeeds, custody cases decrease and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility 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 come next.
At the facility, Stephanie still worried that CPS would come seize her child – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could arrive and separate them.
For the beginning period, Stephanie remained isolated. “I preferred to be alone,” she said. “I was suspicious at that point.”
Homelessness, she said, was about enduring. Addiction came first; faith came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to let her down. She lacked the ability to value herself, let alone anyone else.
Daily, staff from the facility took her to a treatment center, administered in pill form. Slowly, she was beginning recovery.
She spent every minute 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 nutritional guidance. She also had heightened sensory issues and required an professional – all common issues for babies exposed to substances.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. Katie Bunch-Smith, a peer support specialist, visited 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 wonder of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She holds a picture of the moment. She is wearing black pants and a hoodie, a beanie with a bobble on her head, seated on the ground with the entryway at her back. She is slender. Her head is tilted forward so you miss her features. She is presenting her daughter on her leg for the children to see and they are gathered around, showing interest to the baby.
One child, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the dads were busy, handling responsibilities, that they would be there given the chance.
“Once I become a parent,” 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 broke down,” Stephanie said. “When a child recognized that infants need affection, then I was able. I could parent.”
Approaches for managing infants affected by substances have existed for decades.
The assessment tool was created in 1975|
