Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Transformed Their Futures.
Pregnant and experiencing intense discomfort, a woman named Stephanie visited the medical facility after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had built in a companion's property. She was also addicted to fentanyl.
As doctors treated her infection, she started to feel anxious. The onset of withdrawal began. She bent over the bedside and vomited.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and use drugs.”
She had consumed opioids before seeking medical help and had just enough time to get treated before she needed to go home to relapse. She thought she still had several weeks to find a way to become sober and give birth.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was serious, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in substance abuse treatment.
Five days later, on a day in November 2022, Stephanie gave birth to a baby girl weighing 4lb 8oz – born before term, small but alive.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been administered four hours before delivery.
She felt sick. Not ready for motherhood. Unworthy.
Stephanie had sought recovery repeatedly before birth, and felt awful each time she failed. She felt worthless, criticizing herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her supplier would not provide to her when she became visibly pregnant.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her bond with her newborn would make her quit only led to increased guilt 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 overcome a long-term illness.
The infant was moved to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to medical equipment, so tiny she thought she would break her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to call her daughter after her caregiver, after the professional who provided support to her.
Hospital staff told her about a specialized facility, a unique recovery environment where women and their babies are treated together, not apart.
In many parts of America, where a baby is diagnosed with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is proving a simple point: when families are kept intact, recovery succeeds, custody cases decrease and future expenses reduce.
It took Stephanie some time to build confidence to call, but she ultimately reached out. 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, fearful and unsure about what would happen next.
At Maddie’s Place, Stephanie still was concerned that child services would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could arrive and take her baby away.
For the beginning period, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Substances came first; reliance came last.
Stephanie had a trusted ally, but even that relationship was delicate. The those close to her always found ways to hurt her. She lacked the ability to care for herself, let alone anyone else.
Daily, staff from Maddie’s Place took her to a treatment center, provided orally. Over time, she was embracing sobriety.
She utilized each moment outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with adverse reactions to milk and severe digestive problems. She needed feeding therapy. She also had increased sensitivity and required an professional – all frequent conditions 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 sat in the visitation area, where those still using can come for guided meetings with their babies. Katie Bunch-Smith, a peer support specialist, stopped by with her own five kids in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in admiration of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She keeps a photo of the moment. She is dressed in casual attire, a beanie with a bobble on her head, sitting on the wooden floor with the door behind her. She is lean. Her posture is humble so you miss her features. She is holding Izzie up on her knee for the other kids to see and they are standing close, showing interest to the baby.
A young boy, 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.
“When I have kids,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I just lost it and fell apart,” Stephanie said. “When a child recognized that infants need affection, then I could do this. I could parent.”
Methods to address infants affected by substances have been used for a long time.
The evaluation method was established in 1975|
