Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
Pregnant and experiencing intense discomfort, a woman named Stephanie arrived at the medical facility after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she resided in a small structure she had constructed in a friend’s yard. She was also hooked on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Withdrawal was setting in. She bent over the bedside and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had used fentanyl before coming to the ER and had sufficient opportunity to get treated before she was compelled to leave to use once more. She thought she still had four weeks left to figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was critical, but doctors had discovered she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she walked out, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in addiction recovery.
Five days later, on the 12th of November, Stephanie had a daughter weighing just over four pounds – early, small but alive.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was numb. Her pain relief did not work, her final administration of fentanyl had been given a few hours prior to birth.
She felt sick. Not ready for motherhood. Undeserving.
Stephanie had tried to get clean multiple times while expecting, and felt terrible each time she failed. She felt hopeless, blaming herself for not being able to overcome the challenge. An OBGYN told her to “only” stop using. Even her source declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I required assistance.”
The pervasive expectation that her bond with her newborn would make her recover only led to deeper self-loathing and self-abuse, a trigger for her to use again. Yet she could not just wish her addiction away, any more than she could will away a persistent condition.
The infant was moved to the NICU. When Stephanie at last met her, she was hooked up to medical equipment, so tiny she thought she would harm her. Embracing her at last, she felt detached. “I just stared at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to name her baby Izzie, 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 cared for jointly, not apart.
In many parts of America, where a baby is identified with newborn addiction symptoms regularly, infants are still rushed to special care and treated with pharmaceuticals while their mothers face child-protection investigations. But a developing system of centers like this facility is showing an important truth: when mothers and babies stay together, results get better, fewer children enter care and long-term costs decline.
It took Stephanie a while to gather the courage 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, scared and uncertain about what would happen next.
At the facility, Stephanie still was concerned that CPS would come seize her child – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could enter and remove her child.
For the first two weeks, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about enduring. Addiction came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The people she loved always found ways to cause pain. She did not know how to love herself, not to mention anyone else.
Daily, staff from the center took her to a clinic for methadone, provided orally. Over time, she was embracing sobriety.
She devoted all her time beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with intolerance to some formulas and obvious stomach troubles. She needed feeding therapy. She also had heightened sensory issues and required an specialist – 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 could parent.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for monitored interactions with their babies. An advocate, a recovery coach, visited with her own family in tow to drop off cookies. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The young ones stared in admiration of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She has an image of the moment. She is dressed in black pants and a hoodie, a gray knit hat with a pompom on her head, seated on the ground with the exit nearby. She is slender. Her head is tilted forward so you miss her features. She is presenting her daughter on her knee for the young ones to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the moms: “What about the fathers?” The parents responded that the men were occupied, engaged elsewhere, that they would be there if they could.
“Once I become a parent,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and the specialist looked at each other. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that newborns require care, then I found the courage. I would become a mother.”
Methods to address drug-exposed newborns have been used for a long time.
The evaluation method was developed in 1975|
