A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Saved Them Both.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the medical facility after her infection worsened up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had assembled in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie ultimately gave in. “I need to leave. I have to go home and get high.”
She had used fentanyl before coming to the ER and had just enough time to get treated before she had to return to get high again. She thought she still had several weeks to find a way to become sober and have this baby.
The nurse had other ideas. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was serious, but physicians found she also had an ruptured membrane. The nurse, her nurse, warned her: if she left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in addiction recovery.
After five days, on the 12th of November, Stephanie delivered a baby girl weighing 4lb 8oz – born before term, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was detached. Her epidural had failed, her last dose of fentanyl had been administered shortly before she gave birth.
She felt unwell. Not ready for motherhood. Not fit.
Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she was unsuccessful. She felt hopeless, berating herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her source refused to sell to her when she became obviously with child.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her love for her baby 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 simply will her addiction away, any more than she could overcome a persistent condition.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was hooked up to medical equipment, so tiny she thought she would harm her. Cradling her initially, she felt empty. “I just stared at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to give her child the name after her caregiver, after the attendant who showed compassion to her.
Medical personnel told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In much of the US, where a baby is diagnosed with infant withdrawal condition regularly, infants are still whisked to NICUs and medicated while their mothers face custody evaluations. But a developing system of centers like the care home is demonstrating a key fact: when families are kept intact, results get better, fewer children enter care and overall savings increase.
It took Stephanie a period to find strength to call, but she eventually made the call. After confirming she would be a good fit for the program, two staff members came to collect her.
She stepped out of the hospital still in recovery, scared and uncertain about what would come next.
At Maddie’s Place, Stephanie still worried that authorities would come remove her daughter – even though she was uncertain about motherhood. The fear lingered: that at any moment, someone could walk in and take her baby away.
For the initial fortnight, Stephanie remained isolated. “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 survival. Drugs came first; reliance came last.
Stephanie had a single companion, but even that connection was tenuous. The those close to her always found ways to hurt her. She lacked the ability to care for herself, much less anyone else.
Each day, staff from the facility drove her to a clinic for methadone, given as medication. Slowly, she was embracing sobriety.
She utilized each moment when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed nutritional guidance. She also had sensory challenges and required an specialist – all frequent conditions for babies exposed to substances.
When a child recognizes these infants need affection, then I found the strength. I could be a mom.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, came over with her own children in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in awe of the little newborn 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 dressed in black pants and a hoodie, a beanie with a decoration on her head, seated on the ground with the door behind her. She is slender. Her head is tilted forward so you do not see her expression. She is lifting the baby on her leg for the other kids to see and they are standing close, admiring and touching to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The moms tried to explain that the fathers had obligations, engaged elsewhere, that they would be there given the chance.
“When I have kids,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and the specialist looked at each other. “I broke down,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I found the courage. I could parent.”
Approaches for managing babies with exposure have been available for years.
The Finnegan NAS scale was developed in 1975|
