Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Transformed Their Futures.
Eight months pregnant and in severe pain, the expectant mother visited the ER after her infection worsened up her legs. Jobless and without shelter, estranged from her family, she resided in a small structure she had built in a companion's property. She was also addicted to fentanyl.
As medical staff managed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She leaned over the bed and became sick.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and take a hit.”
She had consumed opioids before arriving at the hospital and had just enough time to get treated before she needed to go home to use once more. She thought she still had four weeks left to figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was critical, but medical staff detected she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she walked out, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a medication that eases withdrawal and is often prescribed in addiction recovery.
Five days later, on the 12th of November, Stephanie had a infant weighing 4lb 8oz – early, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was detached. Her anesthesia was ineffective, her final administration of fentanyl had been given shortly before she gave birth.
She felt unwell. Not ready for motherhood. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she relapsed. She felt worthless, blaming herself for not being able to do the impossible. An OBGYN told her to “simply” stop using. Even her source refused to sell to her when she became obviously with child.
“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 deeper self-loathing and negative self-talk, a impetus for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The baby was taken to the neonatal intensive care unit. When Stephanie at last met her, she was attached to tubes and leads, so tiny she thought she would hurt her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
After two days she decided to name her baby Izzie, after the professional who provided support to her.
Hospital staff told her about Maddie’s Place, a innovative treatment home where women and their babies are supported as a unit, not apart.
In many parts of America, where a baby is identified with infant withdrawal condition regularly, infants are still quickly moved to hospitals and given drugs while their mothers face custody evaluations. But a limited but expanding group of centers like Maddie’s Place is proving a simple point: when mothers and babies stay together, results get better, custody cases decrease and long-term costs decline.
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 left the medical center still in detox, scared and uncertain about what would come next.
At the care center, Stephanie still was concerned that CPS would come remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any time, someone could walk in and remove her child.
For the beginning period, Stephanie kept to herself. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about enduring. Addiction came first; reliance came last.
Stephanie had a single companion, but even that connection was tenuous. The those close to her always found ways to hurt her. She was unable to care for herself, not to mention anyone else.
Every day, staff from the center transported her to a clinic for methadone, provided orally. Over time, she was embracing sobriety.
She utilized each moment outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with adverse reactions to milk and obvious stomach troubles. She needed feeding therapy. She also had sensory challenges and required an specialist – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I could do this. I would become a mother.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for supervised visits with their babies. An advocate, a peer support specialist, came over with her own children in tow to bring treats. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in awe of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She has an image of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a pompom on her head, seated on the ground with the entryway at her back. She is thin. Her head is tilted forward so you cannot see her face. She is lifting the baby on her lap for the young ones to see and they are standing close, showing interest to the baby.
One child, eight, asked the moms: “What about the fathers?” The women attempted to clarify that the fathers had obligations, handling responsibilities, that they would be there if they could.
“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and her companion exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I was able. I could be a mom.”
Tools for treating infants affected by substances have been used for a long time.
The assessment tool was created in 1975|
