She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, a woman named Stephanie arrived at the hospital emergency room after an infection began spreading up her legs. Jobless and without shelter, estranged from her family, she stayed in a makeshift shelter she had constructed in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and threw up.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”
She had used fentanyl before arriving at the hospital and had just enough time to get treated before she needed to go home to get high again. She thought she still had several weeks to plan her recovery and have this baby.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was serious, but medical staff detected she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she left, she and her baby would not survive.
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 placed on methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.
Five days later, on the 12th of November, Stephanie delivered a baby girl weighing just over four pounds – born before term, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her last dose of fentanyl had been provided shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she was unsuccessful. She felt without value, criticizing herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her dealer refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The pervasive expectation that her affection for her child would make her quit only led to increased guilt and self-harm, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a chronic disease.
The newborn was transferred to the special care nursery. When Stephanie at last met her, she was hooked up to medical equipment, so little she thought she would harm her. Embracing her at last, she felt detached. “I just stared at her and was like, ‘How will I care for you?’” 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 a care center, a new kind of care center where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a developing system of centers like the care home is demonstrating a key fact: when families are kept intact, outcomes improve, custody cases decrease and long-term costs decline.
It took Stephanie a period to find strength to call, but she ultimately reached out. After verifying her eligibility for the program, a couple of employees came to pick her up.
She left the medical center still in detox, scared and uncertain about what would happen next.
At Maddie’s Place, Stephanie still worried that CPS would come remove her daughter – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could arrive and remove her child.
For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about getting by. Addiction came first; reliance came last.
Stephanie had a single companion, but even that connection was tenuous. The individuals she cared for always found ways to let her down. She was unable to care for herself, let alone anyone else.
Each day, staff from the center drove her to a recovery program, administered in pill form. Gradually, she was beginning recovery.
She devoted all her time outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an occupational therapist – 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 remained in the shared space, where parents in active addiction can come for monitored interactions with their babies. An advocate, a recovery coach, stopped by with her own five kids in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in awe of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She has an image of the moment. She is wearing casual attire, a gray knit hat with a decoration on her head, resting on the floor with the exit nearby. She is slender. Her posture is humble so you miss her features. She is presenting her daughter on her knee for the young ones to see and they are crowding near, showing interest to the baby.
One child, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the fathers had obligations, handling responsibilities, that they would be there if possible.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that newborns require care, then I was able. I would become a mother.”
Approaches for managing drug-exposed newborns have existed for decades.
The evaluation method was established in 1975|
