She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother visited the medical facility after a serious infection started to spread up her legs. Without a job or home, cut off from her relatives, she stayed in a makeshift shelter she had constructed in a companion's property. She was also addicted to fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She slumped forward and threw up.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and take a hit.”
She had consumed opioids before arriving at the hospital and had sufficient opportunity to get treated before she needed to go home to relapse. She thought she still had a month remaining to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the medical facility declined to release her: the leg infection was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is often prescribed in addiction recovery.
Five days later, on the 12th of November, Stephanie gave birth to a baby girl weighing 4lb 8oz – born before term, little but surviving.
When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her pain relief did not work, her last dose of fentanyl had been administered shortly before she gave birth.
She felt ill. Unprepared to be a mother. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she failed. She felt without value, criticizing herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her source declined to supply to her when she became clearly expecting.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her love for her baby would make her quit only led to greater shame and self-abuse, a trigger for her to use again. Yet she could not simply will her addiction away, any more than she could eliminate a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to monitors, so tiny she thought she would hurt her. Embracing her at last, she felt detached. “I gazed upon her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to call her daughter after her caregiver, after the attendant who showed compassion to her.
Hospital staff told her about a care center, a innovative treatment home where women and their babies are treated together, not apart.
In many parts of America, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still quickly moved to hospitals and medicated while their mothers face parental assessments. But a limited but expanding group of centers like the care home is proving a simple point: when families are kept intact, results get better, foster placements fall and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After ensuring she qualified for the program, care providers came to collect her.
She departed the institution still in recovery, scared and uncertain about what would happen next.
At Maddie’s Place, Stephanie still worried that authorities would come take Izzie – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could walk in and separate them.
For the first two weeks, Stephanie kept to herself. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about survival. 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 did not know how to love herself, let alone anyone else.
Daily, staff from the center drove her to a treatment center, provided orally. Over time, she was starting to get clean.
She devoted all her time beyond therapy with Izzie, and could see that her baby was obtaining necessary support 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 occupational therapist – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for guided meetings with their babies. A support specialist, a peer support specialist, visited with her own family in tow to drop off cookies. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in admiration of the tiny infant 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 has an image of the moment. She is clad in casual attire, a beanie with a pompom on her head, resting on the floor with the exit nearby. She is thin. Her face is downcast so you miss her features. She is holding Izzie up on her lap for the other kids to see and they are crowding near, fawning and reaching out to the baby.
One child, eight, asked the parents: “Where are all the dads?” The women attempted to clarify that the men were occupied, called away to other tasks, that they would be there if they could.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I was able. I could be a mom.”
Tools for treating babies with exposure have been available for years.
The evaluation method was created in 1975|
