Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
In her eighth month of pregnancy and suffering, the expectant mother arrived at the hospital emergency room after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she lived in a shed she had built in a acquaintance's garden. 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 vomited.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and get high.”
She had taken the drug before seeking medical help and had sufficient opportunity to get treated before she had to return to get high again. She thought she still had four weeks left to find a way to become sober and deliver her child.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was serious, but physicians found she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.
Five days later, on 12 November 2022, Stephanie delivered a infant weighing just over four pounds – premature, small but alive.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been provided shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Unworthy.
Stephanie had tried to get clean several times during pregnancy, and felt horrible each time she failed. She felt hopeless, criticizing herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her dealer would not provide to her when she became obviously with child.
“However, I failed,” she said. “I needed help.”
The common assumption that her love for her baby would make her recover only led to increased guilt and negative self-talk, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a long-term illness.
The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was hooked up to monitors, so little she thought she would break her. Cradling her initially, she felt nothing. “I gazed upon her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to call her daughter Izzie, after the nurse who had been so kind to her.
Medical personnel told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are treated together, not apart.
In many parts of America, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a limited but expanding group of centers like this facility is showing an important truth: when families are kept intact, recovery succeeds, fewer children enter care and future expenses reduce.
It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, a couple of employees came to pick her up.
She departed the institution still in recovery, fearful and unsure about what would come next.
At the care center, Stephanie still worried that child services would come remove her daughter – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could arrive and remove her child.
For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Addiction came first; trust 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 lacked the ability to value herself, let alone anyone else.
Each day, staff from the center transported her to a clinic for methadone, administered in pill form. Over time, she was embracing sobriety.
She utilized each moment when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and obvious stomach troubles. She needed nutritional guidance. She also had heightened sensory issues and required an specialist – all common issues for babies affected by withdrawal.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where parents in active addiction can come for monitored interactions with their babies. An advocate, a peer support specialist, stopped by with her own children in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in wonder of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She holds a picture of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a decoration on her head, resting on the floor with the entryway at her back. She is lean. Her posture is humble so you do not see her expression. She is presenting her daughter on her knee for the young ones to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the parents: “Where are all the dads?” The women attempted to clarify that the dads were busy, handling responsibilities, 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 her companion made eye contact. “I became emotional,” Stephanie said. “Seeing that even youth understand that infants need affection, then I could do this. I could parent.”
Tools for treating babies with exposure have been used for a long time.
The assessment tool was established in 1975|
