Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
In her eighth month of pregnancy and suffering, the expectant mother arrived at the medical facility after a serious infection started to spread up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had assembled in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. She bent over the bedside and became sick.
Stephanie eventually collapsed. “I need to leave. I have to go home and take a hit.”
She had used fentanyl before arriving at the hospital and had only a brief window to get treated before she had to return to relapse. She thought she still had four weeks left to plan her recovery and have this baby.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was severe, but physicians found she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she departed, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a drug that alleviates cravings and is often prescribed in rehabilitation.
A short time later, on a day in November 2022, Stephanie had a infant weighing just over four pounds – premature, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “I cannot.” She was emotionless. Her pain relief did not work, her final administration of fentanyl had been administered a few hours prior to birth.
She felt unwell. Not ready for motherhood. Undeserving.
Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she was unsuccessful. She felt worthless, blaming herself for not being able to achieve the unattainable. An doctor told her to “only” stop using. Even her source would not provide to her when she became clearly expecting.
“However, I failed,” she said. “I required assistance.”
The widespread belief that her love for her baby would make her recover only led to deeper self-loathing and self-harm, a impetus for her to return to drugs. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was hooked up to monitors, so tiny she thought she would harm her. Embracing her at last, she felt detached. “I just stared at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to call her daughter after her caregiver, after the attendant who showed compassion to her.
Hospital staff told her about a care center, a new kind of care center where women and their babies are cared for jointly, not apart.
In much of the US, where a baby is identified with neonatal abstinence syndrome (NAS) frequently, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a small, growing network of centers like the care home is proving a simple point: when parents and infants remain united, results get better, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After verifying her eligibility for the program, two staff members came to collect her.
She departed the institution still in detox, scared and uncertain about what would happen next.
At the care center, Stephanie still feared that authorities would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any point, someone could enter and take her baby away.
For the beginning period, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about getting by. Substances came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The individuals she cared for always found ways to cause pain. She lacked the ability to love herself, let alone anyone else.
Every day, staff from Maddie’s Place drove her to a treatment center, administered in pill form. Gradually, she was beginning recovery.
She devoted all her time outside treatment 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 severe digestive problems. She needed feeding therapy. She also had increased sensitivity and required an professional – all typical problems for babies affected by withdrawal.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
On a day prior to the holiday, Stephanie sat in the visitation area, where those still using can come for monitored interactions with their babies. A support specialist, a recovery coach, came over with her own family in tow to deliver baked goods. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in wonder of the small baby 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 holds a picture of the moment. She is clad in black pants and a hoodie, a gray knit hat with a bobble on her head, resting on the floor with the exit nearby. She is slender. Her face is downcast so you cannot see her face. She is holding Izzie up on her lap for the other kids to see and they are gathered around, admiring and touching to the baby.
A young boy, eight, asked the moms: “Where are all the dads?” The moms tried to explain that the dads were busy, called away to other tasks, 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 exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I could do this. I could parent.”
Methods to address drug-exposed newborns have been used for a long time.
The assessment tool was established in 1975|
