A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
Pregnant and experiencing intense discomfort, a woman named Stephanie visited the ER after her infection worsened up her legs. Jobless and without shelter, estranged from her family, she stayed in a makeshift shelter she had built in a companion's property. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. Symptoms of withdrawal emerged. She slumped forward and threw up.
Stephanie finally broke down. “I have to get out of here. I have to go home and get high.”
She had used fentanyl before arriving at the hospital and had only a brief window to get treated before she was compelled to leave to use once more. She thought she still had a month remaining to plan her recovery and have this baby.
The nurse had other ideas. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was serious, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is often prescribed in rehabilitation.
After five days, on the 12th of November, Stephanie had a daughter weighing 4lb 8oz – premature, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been provided shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery several times during pregnancy, and felt horrible each time she relapsed. She felt worthless, berating herself for not being able to do the impossible. An obstetrician told her to “just” stop using. Even her source would not provide to her when she became clearly expecting.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her bond with her newborn would make her recover only led to greater shame and self-abuse, a cause for her to return to drugs. Yet she could not just wish her addiction away, any more than she could eliminate a long-term illness.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was hooked up to medical equipment, so tiny she thought she would hurt her. Cradling her initially, she felt empty. “I looked at 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 give her child the name after her caregiver, after the attendant who showed compassion to her.
Nurses and doctors told her about a specialized facility, a innovative treatment home 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) regularly, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a developing system of centers like Maddie’s Place is showing an important truth: when parents and infants remain united, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, two staff members came to bring her to the facility.
She left the medical center still in detox, scared and uncertain about what would follow.
At the care center, Stephanie still feared that CPS would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any point, someone could walk in and separate them.
For the first two weeks, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about enduring. Substances came first; reliance came last.
Stephanie had a trusted ally, but even that connection was tenuous. The individuals she cared for always found ways to cause pain. She lacked the ability to value herself, much less anyone else.
Every day, staff from the facility took her to a clinic for methadone, provided orally. Slowly, she was embracing sobriety.
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 severe digestive problems. She needed feeding therapy. 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 could do this. I could parent.
During a pre-holiday visit, Stephanie was in the common room, where parents in active addiction can come for supervised visits with their babies. A support specialist, a recovery coach, stopped by with her own family in tow to deliver baked goods. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe 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. They focused only on the baby.”
She keeps a photo of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a pompom on her head, seated on the ground with the entryway at her back. She is lean. Her head is tilted forward so you cannot see her face. She is presenting her daughter on her lap for the children to see and they are crowding near, showing interest to the baby.
Jacob, eight, asked the moms: “Why are there no men?” The women attempted to clarify that the fathers had obligations, engaged elsewhere, that they would be there if they could.
“When I have kids,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I was able. I could parent.”
Methods to address drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was created in 1975|
