Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
Pregnant and experiencing intense discomfort, a woman named Stephanie visited the medical facility after an infection began spreading up her legs. Jobless and without shelter, separated from loved ones, she lived in a shed she had assembled in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She leaned over the bed and vomited.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and use drugs.”
She had used fentanyl before seeking medical help and had only a brief window to get treated before she had to return to get high again. She thought she still had a month remaining to figure out how to get clean and give birth.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the leg infection was severe, but medical staff detected she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a medication that eases withdrawal and is frequently utilized in rehabilitation.
After five days, on the 12th of November, Stephanie gave birth to a baby girl weighing 4lb 8oz – early, tiny yet healthy.
When the attendant inquired if she wanted to embrace her child, Stephanie said “I cannot.” She was detached. Her pain relief did not work, her last dose of fentanyl had been provided a few hours prior to birth.
She felt ill. Not ready for motherhood. Undeserving.
Stephanie had tried to get clean repeatedly before birth, and felt horrible each time she relapsed. She felt without value, blaming herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her supplier declined to supply to her when she became visibly pregnant.
“But I couldn’t,” she said. “I required assistance.”
The widespread belief that her bond with her newborn would make her quit only led to deeper self-loathing and self-harm, 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 newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was connected to monitors, so tiny she thought she would harm her. Embracing her at last, she felt detached. “I gazed upon her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to give her child the name Izzie, after the professional who provided support to her.
Hospital staff told her about a specialized facility, a unique recovery environment where women and their babies are treated together, not apart.
In numerous states, where a baby is identified with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still whisked to NICUs 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 mothers and babies stay together, results get better, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After verifying her eligibility for the program, a couple of employees came to collect her.
She stepped out of the hospital still in withdrawal, anxious and doubtful about what would come next.
At the care center, Stephanie still worried that CPS would come remove her daughter – even though she was uncertain about motherhood. The anxiety remained: that at any point, someone could enter and remove her child.
For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about getting by. Substances came first; reliance came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to cause pain. She was unable to care for herself, let alone anyone else.
Every day, staff from the facility transported her to a clinic for methadone, administered in pill form. Over time, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and obvious stomach troubles. She needed feeding therapy. She also had heightened sensory issues and required an specialist – all common issues for babies born with NAS.
Seeing that even a young person understands the need for care, then I could do this. I would become a mother.
On a day prior to the holiday, Stephanie sat in the visitation area, where parents in active addiction can come for supervised visits with their babies. A support specialist, a recovery coach, stopped by with her own family in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in admiration of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She holds a picture of the moment. She is wearing casual attire, a beanie with a decoration on her head, resting on the floor with the door behind her. She is lean. Her head is tilted forward so you miss her features. She is lifting the baby on her knee for the young ones to see and they are gathered around, showing interest to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The women attempted to clarify that the dads were busy, engaged elsewhere, that they would be there if possible.
“In the future,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I became emotional,” Stephanie said. “When a child recognized that newborns require care, then I was able. I could parent.”
Methods to address drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was developed in 1975|
