A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, the expectant mother visited the ER after her infection worsened up her legs. Unemployed and homeless, cut off from her relatives, she resided in a small structure she had constructed in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. Withdrawal was setting in. She bent over the bedside and became sick.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and take a hit.”
She had used fentanyl before seeking medical help and had sufficient opportunity to get treated before she needed to go home to relapse. She thought she still had four weeks left to plan her recovery and deliver her child.
The attending nurse disagreed. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the leg infection was severe, but physicians found she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she left, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be placed on methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie delivered a baby girl weighing a small weight – premature, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been given four hours before delivery.
She felt unwell. Not ready for motherhood. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she relapsed. She felt hopeless, blaming herself for not being able to do the impossible. An doctor told her to “just” stop using. Even her source refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The common assumption that her affection for her child would make her stop using only led to increased guilt and negative self-talk, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could overcome a long-term illness.
The baby was taken to the neonatal intensive care unit. When Stephanie at last met her, she was attached to tubes and leads, so tiny she thought she would hurt her. Cradling her initially, she felt empty. “I gazed upon 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 the same as her nurse, after the professional who provided support 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 numerous states, where a baby is identified with infant withdrawal condition every 18 minutes, infants are still whisked to NICUs and given drugs while their mothers face custody evaluations. But a small, growing network of centers like Maddie’s Place is showing an important truth: when parents and infants remain united, outcomes improve, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, care providers came to pick her up.
She stepped out of the hospital still in recovery, anxious and doubtful about what would follow.
At the care center, Stephanie still was concerned that child services would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any time, someone could arrive and separate them.
For the first two weeks, Stephanie remained isolated. “I preferred to be alone,” she said. “I lacked confidence 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 relationship was delicate. The individuals she cared for always found ways to let her down. She lacked the ability to value herself, let alone anyone else.
Each day, staff from the center transported her to a recovery program, provided orally. Over time, she was starting to get clean.
She utilized each moment outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed dietary support. She also had sensory challenges and required an specialist – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I was capable. I could parent.
On a day prior to the holiday, Stephanie sat in the visitation area, where those still using can come for guided meetings with their babies. An advocate, a peer support specialist, came over with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She has an image of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a decoration on her head, seated on the ground with the exit nearby. She is slender. Her posture is humble so you cannot see her face. She is holding Izzie up on her knee for the children to see and they are standing close, admiring and touching to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The parents responded that the fathers had obligations, called away to other tasks, that they would be there given the chance.
“When I have kids,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I could parent.”
Approaches for managing infants affected by substances have been used for a long time.
The Finnegan NAS scale was developed in 1975|
