Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
Eight months pregnant and in severe pain, a woman named Stephanie visited the hospital emergency room after her infection worsened up her legs. Unemployed and homeless, cut off from her relatives, she lived in a shed she had assembled in a acquaintance's garden. She was also hooked on fentanyl.
As physicians addressed her infection, she began to panic. The onset of withdrawal began. She leaned over the bed and became sick.
Stephanie finally broke down. “I have to get out of here. I have to go home and take a hit.”
She had consumed opioids before seeking medical help 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 find a way to become sober and have this baby.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the hospital refused to discharge 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 departed, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is frequently utilized in rehabilitation.
After five days, on a day in November 2022, Stephanie had a baby girl weighing just over four pounds – born before term, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was emotionless. Her epidural had failed, her final administration of fentanyl had been administered shortly before she gave birth.
She felt ill. Unprepared to be a mother. Undeserving.
Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she failed. She felt without value, berating herself for not being able to do the impossible. An doctor told her to “only” stop using. Even her supplier refused to sell to her when she became clearly expecting.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her affection for her child would make her recover only led to deeper self-loathing and self-harm, a cause for her to return to drugs. Yet she could not easily command her addiction away, any more than she could will away a persistent condition.
The infant was moved to the NICU. When Stephanie eventually visited her, she was hooked up to monitors, so tiny she thought she would harm her. Cradling her initially, she felt nothing. “I just stared at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to give her child the name Izzie, after the attendant who showed compassion to her.
Medical personnel told her about a care center, a new kind of care center where women and their babies are treated together, not apart.
In numerous states, where a baby is identified with neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs and given drugs while their mothers face custody evaluations. But a small, growing network of centers like the care home is showing an important truth: when families are kept intact, results get better, custody cases decrease and future expenses reduce.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, a couple of employees came to pick her up.
She departed the institution still in detox, fearful and unsure about what would come next.
At Maddie’s Place, Stephanie still feared that CPS would come remove her daughter – even though she was hesitant about parenting. The concern persisted: that at any point, someone could walk in and separate them.
For the beginning period, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about getting by. Addiction came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She was unable to care for herself, much less anyone else.
Each day, staff from the facility drove her to a recovery program, given as medication. Gradually, she was starting to get clean.
She devoted all her time beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an professional – all common issues for babies born with NAS.
Seeing that even a young person understands the need for care, then I could do this. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where parents in active addiction can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, visited with her own children in tow to bring treats. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in admiration of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She has an image of the moment. She is wearing casual attire, a beanie with a pompom on her head, resting on the floor with the exit nearby. She is thin. Her head is tilted forward so you cannot see her face. She is lifting the baby on her leg for the other kids to see and they are crowding near, fawning and reaching out to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The moms tried to explain that the fathers had obligations, handling responsibilities, that they would be there given the chance.
“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 exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I could do this. I could be a mom.”
Tools for treating drug-exposed newborns have been available for years.
The Finnegan NAS scale was created in 1975|
