A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
Eight months pregnant and in severe pain, a woman named Stephanie arrived at the ER after a serious infection started to spread up her legs. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had assembled in a acquaintance's garden. She was also hooked on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She bent over the bedside and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and take a hit.”
She had consumed opioids before seeking medical help 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 figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was serious, 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 regulated amounts of fentanyl periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is often prescribed in addiction recovery.
Five days later, on the 12th of November, Stephanie gave birth to a daughter weighing just over four pounds – premature, little but surviving.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was emotionless. Her pain relief did not work, her final administration of fentanyl had been provided a few hours prior to birth.
She felt ill. Unprepared to be a mother. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt terrible each time she was unsuccessful. She felt without value, berating herself for not being able to do the impossible. An doctor told her to “only” stop using. Even her dealer would not provide to her when she became visibly pregnant.
“However, I failed,” she said. “I needed help.”
The widespread belief that her love for her baby would make her recover only led to greater shame and negative self-talk, a impetus for her to return to drugs. Yet she could not easily command her addiction away, any more than she could overcome a long-term illness.
The infant was moved to the NICU. When Stephanie eventually visited her, she was connected to tubes and leads, so tiny she thought she would harm her. Cradling her initially, she felt empty. “I just stared at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to name her baby after her caregiver, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are cared for jointly, not apart.
In numerous states, where a baby is identified with newborn addiction symptoms frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face custody evaluations. But a limited but expanding group of centers like Maddie’s Place is proving a simple point: when families are kept intact, results get better, fewer children enter care and overall savings increase.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, a couple of employees came to bring her to the facility.
She stepped out of the hospital still in withdrawal, fearful and unsure about what would happen next.
At the facility, Stephanie still feared that CPS would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any time, someone could enter and remove her child.
For the initial fortnight, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about survival. Substances came first; faith 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 care for herself, much less anyone else.
Each day, staff from the facility transported her to a recovery program, provided orally. Slowly, she was starting to get clean.
She spent every minute beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an professional – all common issues for babies exposed to substances.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
During a pre-holiday visit, Stephanie was in the common room, where individuals struggling with substance use 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 kids looked amazed in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She has an image of the moment. She is wearing casual attire, a gray knit hat with a bobble on her head, seated on the ground with the door behind her. She is slender. Her head is tilted forward so you miss her features. She is presenting her daughter on her lap for the other kids to see and they are crowding near, admiring and touching to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The moms tried to explain that the fathers had obligations, handling responsibilities, that they would be there if possible.
“In the future,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith looked at each other. “I just lost it and fell apart,” Stephanie said. “When a child recognized that newborns require care, then I could do this. I could be a mom.”
Methods to address babies with exposure have been used for a long time.
The Finnegan NAS scale was developed in 1975|
