Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, a woman named Stephanie went to the hospital emergency room after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had constructed in a acquaintance's garden. She was also dependent on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Withdrawal was setting in. She slumped forward and threw up.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and take a hit.”
She had taken the drug before arriving at the hospital and had sufficient opportunity to get treated before she needed to go home to get high again. She thought she still had several weeks to plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the infection in her legs was serious, but doctors had discovered 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 at regular intervals, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in substance abuse treatment.
After five days, on the 12th of November, Stephanie delivered a infant weighing 4lb 8oz – premature, small but alive.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her epidural had failed, her final administration of fentanyl had been administered four hours before delivery.
She felt sick. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she was unsuccessful. She felt without value, berating herself for not being able to overcome the challenge. An OBGYN told her to “simply” stop using. Even her source declined to supply to her when she became clearly expecting.
“However, I failed,” she said. “I had to seek support.”
The common assumption that her bond with her newborn would make her stop using only led to deeper self-loathing and negative self-talk, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a persistent condition.
The baby was taken to the special care nursery. When Stephanie eventually visited her, she was hooked up to tubes and leads, so tiny she thought she would break her. Cradling her initially, she felt detached. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to name her baby after her caregiver, after the professional who provided support to her.
Hospital staff told her about a specialized facility, a new kind of care center where parents and infants affected by substance use are supported as a unit, not apart.
In numerous states, where a baby is identified with neonatal abstinence syndrome (NAS) every 18 minutes, 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 demonstrating a key fact: when parents and infants remain united, results get better, foster placements fall and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After ensuring she qualified for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in withdrawal, anxious and doubtful about what would follow.
At the care center, Stephanie still was concerned that authorities would come take Izzie – even though she was hesitant about parenting. The concern persisted: that at any point, someone could walk in and separate them.
For the first two weeks, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Substances came first; reliance came last.
Stephanie had a single companion, but even that connection was tenuous. The individuals she cared for always found ways to hurt her. She did not know how to value herself, not to mention anyone else.
Every day, staff from the facility drove her to a recovery program, given as medication. Slowly, 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 girl had some trouble feeding at first, with adverse reactions to milk and obvious stomach troubles. She needed nutritional guidance. She also had sensory challenges and required an specialist – all common issues for babies born with NAS.
Seeing that even a young person understands the need for care, then I was capable. I would become a mother.
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 peer support specialist, came over with her own family in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The young ones stared in awe of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She keeps a photo of the moment. She is clad in casual attire, a gray knit hat with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is lean. Her face is downcast so you miss her features. She is presenting her daughter on her lap for the young ones to see and they are crowding near, fawning and reaching out to the baby.
Jacob, eight, asked the mothers: “Where are all the dads?” 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 will teach them about love.”
Stephanie and her companion looked at each other. “I broke down,” 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 drug-exposed newborns have been available for years.
The assessment tool was developed in 1975|
