Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Rescued Both Lives.
Eight months pregnant and in severe pain, the expectant mother visited the ER after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she stayed in a makeshift shelter she had constructed in a companion's property. She was also hooked on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Withdrawal was setting in. She slumped forward and threw up.
Stephanie ultimately gave in. “I need to leave. I have to go home and use drugs.”
She had consumed opioids before coming to the ER and had just enough time to get treated before she had to return to relapse. She thought she still had a month remaining to find a way to become sober and deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the medical facility declined to release her: the leg infection was critical, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that symptoms could threaten 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.
Five days later, on the 12th of November, Stephanie had a infant weighing a small weight – early, tiny yet healthy.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was detached. Her pain relief did not work, her last dose of fentanyl had been administered a few hours prior to birth.
She felt sick. Unprepared to be a mother. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she was unsuccessful. She felt without value, criticizing herself for not being able to achieve the unattainable. An OBGYN told her to “just” stop using. Even her source would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The common assumption that her bond with her newborn would make her stop using only led to greater shame and negative self-talk, a impetus for her to return to drugs. Yet she could not just wish her addiction away, any more than she could eliminate a persistent condition.
The infant was moved to the NICU. When Stephanie finally saw her her, she was hooked up to tubes and leads, so small she thought she would harm her. Holding her for the first time, she felt empty. “I looked at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
After two days she decided to call her daughter after her caregiver, after the professional who provided support to her.
Medical personnel 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 found to have infant withdrawal condition regularly, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like this facility is showing an important truth: when parents and infants remain united, outcomes improve, foster placements fall and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After verifying her eligibility for the program, two staff members came to bring her to the facility.
She departed the institution still in detox, scared and uncertain about what would come next.
At the care center, Stephanie still worried that child services would come remove her daughter – even though she was not sure she wanted to keep her. The fear lingered: that at any point, someone could walk in and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about enduring. Substances came first; trust came last.
Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to let her down. She did not know how to value herself, not to mention anyone else.
Daily, staff from the facility transported her to a recovery program, administered in pill form. Gradually, she was embracing sobriety.
She devoted all her time 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 adverse reactions to milk and obvious stomach troubles. She needed dietary support. She also had increased sensitivity and required an specialist – all typical problems for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I found the strength. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where parents in active addiction can come for supervised visits with their babies. Katie Bunch-Smith, a mentor, visited with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in wonder 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. Such issues were irrelevant.”
She has an image of the moment. She is wearing black pants and a hoodie, a beanie with a bobble on her head, sitting on the wooden floor with the entryway at her back. She is slender. Her face is downcast so you cannot see her face. She is lifting the baby on her knee for the other kids to see and they are standing close, admiring and touching to the baby.
One child, eight, asked the moms: “What about the fathers?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there given the chance.
“In the future,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I became emotional,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I could do this. I could parent.”
Tools for treating infants affected by substances have existed for decades.
The assessment tool was established in 1975|
