Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
Pregnant and experiencing intense discomfort, a woman named Stephanie visited the medical facility after her infection worsened up her legs. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had built in a friend’s yard. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. The onset of withdrawal began. She bent over the bedside and vomited.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and use drugs.”
She had consumed opioids before coming to the ER and had sufficient opportunity to get treated before she had to return to relapse. She thought she still had several weeks to figure out how to get clean and deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was critical, but medical staff detected she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she walked out, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is frequently utilized in addiction recovery.
Five days later, on the 12th of November, Stephanie had a daughter weighing 4lb 8oz – early, small but alive.
When the attendant inquired if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her pain relief did not work, her previous intake of fentanyl had been given four hours before delivery.
She felt sick. Ill-equipped for parenting. Unworthy.
Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she failed. She felt worthless, criticizing herself for not being able to do the impossible. An doctor told her to “just” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“Yet I was unable,” she said. “I required assistance.”
The widespread belief that her affection for her child would make her recover only led to increased guilt and self-abuse, a impetus for her to relapse. Yet she could not just wish her addiction away, any more than she could overcome a chronic disease.
The infant was moved to the NICU. When Stephanie at last met her, she was hooked up to tubes and leads, so small 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.
Hospital staff told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are treated together, not apart.
In much of the US, where a baby is found to have newborn addiction symptoms regularly, infants are still quickly moved to hospitals and medicated while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is showing an important truth: when families are kept intact, results get better, fewer children enter care and future expenses reduce.
It took Stephanie some time to build confidence to call, but she eventually made the call. After ensuring she qualified for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in recovery, scared and uncertain about what would happen next.
At the facility, Stephanie still worried that authorities would come seize her child – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could enter and take her baby away.
For the initial fortnight, Stephanie remained isolated. “I preferred to be alone,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Addiction came first; trust came last.
Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to hurt her. She did not know how to value herself, much less anyone else.
Daily, staff from the facility transported her to a recovery program, given as medication. Gradually, she was embracing sobriety.
She devoted all her time outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had sensory challenges and required an occupational therapist – all frequent conditions for babies exposed to substances.
Seeing that even a young person understands the need for care, then I was capable. I would become a mother.
On a day prior to the holiday, Stephanie was in the common room, where those still using can come for guided meetings with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own children in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The young ones stared in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She holds a picture of the moment. She is dressed in black pants and a hoodie, a cap with a bobble on her head, seated on the ground with the entryway at her back. She is slender. Her posture is humble so you miss her features. She is lifting the baby on her leg for the young ones to see and they are crowding near, admiring and touching to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The moms tried to explain that the men were occupied, called away to other tasks, that they would be there if they could.
“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and her companion made eye contact. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I could parent.”
Tools for treating babies with exposure have existed for decades.
The evaluation method was developed in 1975|
