Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, a woman named Stephanie went to the ER after an infection began spreading up her legs. Jobless and without shelter, cut off from her relatives, she lived in a shed she had constructed in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She bent over the bedside and became sick.
Stephanie ultimately gave in. “I need to leave. I have to go home and use drugs.”
She had consumed opioids before coming to the ER and had only a brief window to get treated before she needed to go home to relapse. She thought she still had a month remaining 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 am leaving,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she left, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.
After five days, on the 12th of November, Stephanie had a baby girl weighing a small weight – premature, tiny yet healthy.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been given a few hours prior to birth.
She felt ill. Not ready for motherhood. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt horrible each time she failed. She felt hopeless, blaming herself for not being able to do the impossible. An OBGYN told her to “simply” 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 widespread belief that her affection for her child would make her recover only led to greater shame and self-abuse, a cause for her to relapse. Yet she could not simply will her addiction away, any more than she could will away a persistent condition.
The infant was moved to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to monitors, so small she thought she would break her. Embracing her at last, she felt empty. “I gazed upon 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 call her daughter the same as her nurse, after the attendant who showed compassion to her.
Medical personnel told her about a care center, a innovative treatment home where women and their babies are cared for jointly, not apart.
In many parts of America, where a baby is found to have infant withdrawal condition every 18 minutes, infants are still quickly moved to hospitals and given drugs while their mothers face child-protection investigations. But a developing system of centers like this facility is proving a simple point: when mothers and babies stay together, recovery succeeds, foster placements fall 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, two staff members came to collect her.
She stepped out of the hospital still in detox, anxious and doubtful about what would follow.
At the care center, Stephanie still was concerned that authorities would come remove her daughter – even though she was uncertain about motherhood. The anxiety remained: that at any point, someone could enter and take her baby away.
For the initial fortnight, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about enduring. Drugs came first; reliance came last.
Stephanie had one close friend, but even that connection was tenuous. The those close to her always found ways to cause pain. She lacked the ability to love herself, much less anyone else.
Daily, staff from the facility took her to a clinic for methadone, administered in pill form. Slowly, she was embracing sobriety.
She spent every minute 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 obvious stomach troubles. She needed nutritional guidance. She also had sensory challenges and required an specialist – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I could do this. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for monitored interactions with their babies. A support specialist, a peer support specialist, stopped by with her own children in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in admiration of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She holds a picture of the moment. She is dressed in casual attire, a beanie with a pompom on her head, seated on the ground with the entryway at her back. She is thin. Her posture is humble so you do not see her expression. She is holding Izzie up on her lap for the young ones to see and they are crowding near, admiring and touching to the baby.
A young boy, eight, asked the moms: “Where are all the dads?” The parents responded that the fathers had obligations, engaged elsewhere, that they would be there if they could.
“In the future,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and the specialist made eye contact. “I became emotional,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.”
Tools for treating infants affected by substances have existed for decades.
The Finnegan NAS scale was established in 1975|
