She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother arrived at the medical facility after her infection worsened 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 hooked on fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She leaned over the bed and vomited.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before seeking medical help and had just enough time to get treated before she had to return to relapse. She thought she still had a month remaining to plan her recovery and give birth.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the infection in her legs was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she walked out, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be transitioned to methadone, a medication that eases withdrawal and is often prescribed in addiction recovery.
After five days, on the 12th of November, Stephanie had a baby girl weighing a small weight – early, small but alive.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was detached. Her pain relief did not work, her last dose of fentanyl had been given a few hours prior to birth.
She felt ill. Unprepared to be a mother. Undeserving.
Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she relapsed. She felt hopeless, criticizing herself for not being able to do the impossible. An doctor told her to “just” stop using. Even her supplier would not provide to her when she became clearly expecting.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her recover only led to greater shame and negative self-talk, a cause for her to return to drugs. Yet she could not just wish her addiction away, any more than she could will away a persistent condition.
The newborn was transferred to the neonatal intensive care unit. When Stephanie at last met her, she was attached to monitors, so small she thought she would break her. Cradling her initially, she felt nothing. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to call her daughter after her caregiver, after the nurse who had been so kind to her.
Hospital staff told her about a care center, a new kind of care center where parents and infants affected by substance use are treated together, not apart.
In much of the US, where a baby is diagnosed with infant withdrawal condition frequently, infants are still rushed to special care and given drugs while their mothers face custody evaluations. But a small, growing network of centers like the care home is proving a simple point: when families are kept intact, outcomes improve, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage 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 recovery, fearful and unsure about what would follow.
At Maddie’s Place, Stephanie still feared that authorities would come seize her child – even though she was hesitant about parenting. The concern persisted: that at any time, someone could arrive and separate them.
For the initial fortnight, Stephanie remained isolated. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Addiction came first; trust came last.
Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to let her down. She lacked the ability to care for herself, much less anyone else.
Every day, staff from the center took her to a recovery program, given as medication. Gradually, she was beginning recovery.
She utilized each moment when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and severe digestive problems. She needed nutritional guidance. She also had increased sensitivity and required an occupational therapist – all typical problems for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I was capable. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where those still using can come for supervised visits with their babies. A support specialist, a mentor, came over with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a decoration on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her head is tilted forward so you do not see her expression. She is lifting the baby on her knee for the children to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the moms: “What about the fathers?” The parents responded that the men were occupied, called away to other tasks, that they would be there if possible.
“Once I become a parent,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist 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.”
Methods to address infants affected by substances have existed for decades.
The Finnegan NAS scale was established in 1975|
