Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child 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 constructed in a companion's property. She was also hooked on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She bent over the bedside and became sick.
Stephanie ultimately gave in. “I need to leave. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had sufficient opportunity to get treated before she had to return to get high again. She thought she still had several weeks to find a way to become sober and deliver her child.
The nurse had other ideas. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was critical, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is frequently utilized in rehabilitation.
A short time later, on 12 November 2022, Stephanie delivered a baby girl weighing 4lb 8oz – born before term, small but alive.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been administered a few hours prior to birth.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she relapsed. She felt hopeless, criticizing herself for not being able to do the impossible. An obstetrician told her to “only” stop using. Even her supplier refused to sell to her when she became obviously with child.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her bond with her newborn would make her quit only led to deeper self-loathing and self-harm, a trigger for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.
The infant was moved to the NICU. When Stephanie finally saw her her, she was connected to tubes and leads, so small she thought she would break her. Holding her for the first time, she felt detached. “I looked at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
After two days she decided to call her daughter Izzie, after the attendant who showed compassion to her.
Hospital staff told her about a specialized facility, a innovative treatment home where women and their babies are treated together, not apart.
In many parts of America, where a baby is found to have neonatal abstinence syndrome (NAS) every 18 minutes, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a small, growing network of centers like the care home is showing an important truth: when parents and infants remain united, results get better, foster placements fall and long-term costs decline.
It took Stephanie some time to build confidence to call, but she finally did. After verifying her eligibility for the program, care providers came to pick her up.
She left the medical center still in detox, fearful and unsure about what would follow.
At the care center, Stephanie still worried that child services would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any point, someone could walk in and separate them.
For the first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about getting by. Drugs came first; trust 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 did not know how to love herself, much less anyone else.
Each day, staff from the center transported her to a recovery program, provided orally. Slowly, she was beginning recovery.
She spent every minute beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had heightened sensory issues and required an occupational therapist – all typical problems for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I could do this. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for supervised visits with their babies. A support specialist, a mentor, came over with her own children in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in admiration of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
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 slender. Her posture is humble so you cannot see her face. She is presenting her daughter on her knee for the children to see and they are standing close, showing interest to the baby.
One child, eight, asked the parents: “What about the fathers?” The parents responded that the dads were busy, called away to other tasks, that they would be there if they could.
“In the future,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist made eye contact. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I could parent.”
Tools for treating babies with exposure have been used for a long time.
The Finnegan NAS scale was created in 1975|
