Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
In her eighth month of pregnancy and suffering, the expectant mother visited the medical facility after her infection worsened up her legs. Jobless and without shelter, estranged from her family, she resided in a small structure she had built in a acquaintance's garden. She was also addicted to fentanyl.
As physicians addressed her infection, she started to feel anxious. The onset of withdrawal began. She slumped forward and vomited.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and get high.”
She had used fentanyl before arriving at the hospital and had only a brief window to get treated before she had to return to get high again. She thought she still had several weeks to plan her recovery and deliver her child.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the infection in her legs was critical, but medical staff detected she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be placed on methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.
Five days later, on a day in November 2022, Stephanie delivered a daughter weighing just over four pounds – premature, little but surviving.
When the nurse asked if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been provided shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she was unsuccessful. She felt hopeless, criticizing herself for not being able to overcome the challenge. An OBGYN told her to “only” stop using. Even her source would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The common assumption that her love for her baby would make her quit only led to increased guilt and negative self-talk, a trigger for her to return to drugs. Yet she could not just wish her addiction away, any more than she could eliminate a long-term illness.
The baby was taken to the special care nursery. When Stephanie at last met her, she was connected to monitors, so small she thought she would harm her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the professional who provided support to her.
Hospital staff told her about Maddie’s Place, a new kind of care center where women and their babies are treated together, not apart.
In numerous states, where a baby is found to have newborn addiction symptoms every 18 minutes, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face parental assessments. But a small, growing network of centers like this facility is showing an important truth: when parents and infants remain united, recovery succeeds, fewer children enter care and long-term costs decline.
It took Stephanie some time to build confidence to call, but she finally did. After confirming she would be a good fit for the program, two staff members came to pick her up.
She stepped out of the hospital still in withdrawal, fearful and unsure about what would follow.
At Maddie’s Place, Stephanie still was concerned that CPS would come take Izzie – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could arrive and take her baby away.
For the beginning period, Stephanie kept to herself. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about survival. Substances came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to let her down. She did not know how to love herself, not to mention anyone else.
Each day, staff from the center transported her to a treatment center, administered in pill form. Slowly, she was starting to get clean.
She spent every minute when not in sessions 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 pronounced gastrointestinal issues. She needed dietary support. She also had heightened sensory issues and required an specialist – all common issues for babies exposed to substances.
Seeing that even a young person understands the need for care, then I found the strength. 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. Katie Bunch-Smith, a peer support specialist, visited with her own family in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in admiration of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She holds a picture of the moment. She is clad in casual attire, a gray knit hat with a bobble on her head, seated on the ground with the exit nearby. She is thin. Her posture is humble so you miss her features. She is lifting the baby on her leg for the other kids to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the moms: “Where are all the dads?” The parents responded that the dads were busy, called away to other tasks, that they would be there if possible.
“In the future,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and the specialist made eye contact. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I found the courage. I would become a mother.”
Approaches for managing babies with exposure have been used for a long time.
The Finnegan NAS scale was created in 1975|
