Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother went to the medical facility 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 constructed in a acquaintance's garden. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She slumped forward and vomited.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had taken the drug 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 a month remaining to figure out how to get clean and deliver her child.
The attending nurse disagreed. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be placed on methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.
Five days later, on a day in November 2022, Stephanie gave birth to a baby girl weighing a small weight – premature, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “not now.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been administered four hours before delivery.
She felt ill. Ill-equipped for parenting. Undeserving.
Stephanie had tried to get clean repeatedly before birth, and felt horrible each time she relapsed. She felt without value, blaming herself for not being able to do the impossible. An obstetrician told her to “just” stop using. Even her supplier would not provide to her when she became obviously with child.
“However, I failed,” she said. “I required assistance.”
The widespread belief that her bond with her newborn would make her stop using only led to increased guilt and self-harm, a trigger for her to return to drugs. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The infant was moved to the NICU. When Stephanie eventually visited her, she was connected to tubes and leads, so little she thought she would hurt her. Cradling her initially, she felt detached. “I gazed upon her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Two days later she decided to name her baby after her caregiver, after the professional who provided support 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 identified with infant withdrawal condition regularly, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a developing system of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, recovery succeeds, foster placements fall and future expenses reduce.
It took Stephanie a period to find strength to call, but she ultimately reached out. After confirming she would be a good fit for the program, a couple of employees came to pick her up.
She left the medical center still in withdrawal, anxious and doubtful about what would come next.
At Maddie’s Place, Stephanie still was concerned that authorities would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any time, someone could enter and take her baby away.
For the first two weeks, Stephanie remained isolated. “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 enduring. Drugs came first; reliance came last.
Stephanie had a single companion, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She lacked the ability to care for herself, let alone anyone else.
Every day, staff from the facility transported her to a clinic for methadone, administered in pill form. Over time, she was starting to get clean.
She utilized each moment when not in sessions 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 obvious stomach troubles. She needed dietary support. She also had heightened sensory issues and required an professional – all frequent conditions for babies exposed to substances.
Seeing that even a young person understands the need for care, then I could do this. I could be a mom.
During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a recovery coach, visited with her own family in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in wonder of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She keeps a photo of the moment. She is wearing casual attire, a beanie with a bobble on her head, resting on the floor with the entryway at her back. She is thin. Her posture is humble so you do not see her expression. She is holding Izzie up on her lap for the young ones to see and they are crowding near, fawning and reaching out to the baby.
A young boy, eight, asked the moms: “Where are all the dads?” The parents responded that the fathers had obligations, engaged elsewhere, that they would be there if possible.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that infants need affection, then I was able. I could parent.”
Methods to address infants affected by substances have been used for a long time.
The evaluation method was created in 1975|
