Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, the expectant mother visited the medical facility after an infection began spreading up her legs. Unemployed and homeless, cut off from her relatives, she resided in a small structure she had constructed in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She slumped forward and vomited.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and get high.”
She had taken the drug before arriving at the hospital and had just enough time to get treated before she was compelled to leave to relapse. She thought she still had several weeks to figure out how to get clean and have this baby.
The medical professional intervened. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the doctors would not let her go: the infection in her legs was severe, but doctors had discovered she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in substance abuse treatment.
After five days, on a day in November 2022, Stephanie had a baby girl weighing a small weight – born before term, little but surviving.
When the attendant inquired if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been administered four hours before delivery.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had tried to get clean several times during pregnancy, and felt terrible each time she failed. She felt hopeless, criticizing herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her dealer refused to sell to her when she became obviously with child.
“However, I failed,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her stop using only led to deeper self-loathing and self-harm, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was connected to medical equipment, so tiny she thought she would hurt her. Cradling her initially, she felt nothing. “I looked 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 the same as her nurse, after the nurse who had been so kind to her.
Nurses and doctors told her about Maddie’s Place, a innovative treatment home where parents and infants affected by substance use are treated together, not apart.
In many parts of America, where a baby is diagnosed with infant withdrawal condition regularly, infants are still rushed to special care and treated with pharmaceuticals while their mothers face custody evaluations. But a limited but expanding group of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in withdrawal, anxious and doubtful about what would follow.
At the care center, Stephanie still worried that child services would come take Izzie – even though she was hesitant about parenting. The concern persisted: that at any moment, someone could walk in and take her baby away.
For the first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about getting by. Substances came first; reliance came last.
Stephanie had a trusted ally, but even that connection was tenuous. The individuals she cared for always found ways to hurt her. She lacked the ability to value herself, not to mention anyone else.
Each day, staff from the facility took her to a treatment center, administered in pill form. Slowly, she was starting to get clean.
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 intolerance to some formulas and pronounced gastrointestinal issues. She needed dietary support. She also had increased sensitivity and required an professional – all common issues for babies born with NAS.
When a child recognizes these infants need affection, then I was capable. I could parent.
On a day prior to the holiday, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. A support specialist, a recovery coach, visited with her own five kids in tow to drop off cookies. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in wonder 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 holds a picture of the moment. She is dressed in dark trousers and a sweatshirt, a cap with a decoration on her head, resting on the floor with the door behind her. She is thin. Her head is tilted forward so you do not see her expression. She is holding Izzie up on her knee for the children to see and they are gathered around, admiring and touching to the baby.
Jacob, eight, asked the mothers: “Why are there no men?” The moms tried to explain that the men were occupied, engaged elsewhere, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist exchanged glances. “I broke down,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I found the courage. I could parent.”
Methods to address infants affected by substances have been available for years.
The Finnegan NAS scale was created in 1975|
