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 medical facility after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had assembled in a friend’s yard. She was also hooked on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and vomited.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and take a hit.”
She had consumed opioids before coming to the ER and had sufficient opportunity to get treated before she had to return to get high again. She thought she still had four weeks left to plan her recovery and have this baby.
The nurse had other ideas. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was severe, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that abstinence might harm her and the baby. After delivery Stephanie would be transitioned to methadone, a drug that alleviates cravings and is often prescribed in addiction recovery.
A short time later, on 12 November 2022, Stephanie gave birth to a infant weighing just over four pounds – early, tiny yet healthy.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was detached. Her epidural had failed, her last dose of fentanyl had been given a few hours prior to birth.
She felt ill. Not ready for motherhood. Undeserving.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she relapsed. She felt worthless, berating herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her supplier declined to supply to her when she became clearly expecting.
“But I couldn’t,” she said. “I needed help.”
The widespread belief that her love for her baby would make her recover only led to deeper self-loathing and self-harm, a trigger for her to use again. Yet she could not simply will her addiction away, any more than she could eliminate a long-term illness.
The baby was taken to the neonatal intensive care unit. When Stephanie finally saw her her, she was connected to monitors, so small she thought she would harm her. Holding her for the first time, she felt empty. “I gazed upon her and was like, ‘How will I care for you?’” She still wasn’t sure 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.
Medical personnel told her about a care center, a new kind of care center where mothers and their drug-exposed newborns are treated together, not apart.
In many parts of America, where a baby is identified with neonatal abstinence syndrome (NAS) frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a limited but expanding group of centers like the care home is showing an important truth: when families are kept intact, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie a period to find strength 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 detox, fearful and unsure about what would happen next.
At Maddie’s Place, Stephanie still worried that child services would come remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any time, someone could arrive and remove her child.
For the beginning period, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about enduring. 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 love herself, much less anyone else.
Each day, staff from the facility transported her to a treatment center, given as medication. Slowly, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed feeding therapy. She also had increased sensitivity and required an occupational therapist – all common issues for babies affected by withdrawal.
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 sat in the visitation area, where those still using can come for guided meetings with their babies. An advocate, a recovery coach, stopped by with her own five kids in tow to drop off cookies. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The young ones stared in awe of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is wearing black pants and a hoodie, a beanie with a decoration on her head, resting on the floor with the door behind her. She is slender. Her face is downcast so you do not see her expression. She is holding Izzie up on her lap for the children to see and they are crowding near, fawning and reaching out to the baby.
A young boy, eight, asked the parents: “Why are there no men?” The women attempted to clarify that the fathers had obligations, engaged elsewhere, 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 exchanged glances. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I found the courage. I would become a mother.”
Approaches for managing infants affected by substances have been used for a long time.
The Finnegan NAS scale was developed in 1975|
