A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Transformed Their Futures.
In her eighth month of pregnancy and suffering, the expectant mother went to the medical facility after an infection began spreading up her legs. Jobless and without shelter, estranged from her family, she stayed in a makeshift shelter she had assembled in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she started to feel anxious. The onset of withdrawal began. She slumped forward and became sick.
Stephanie finally broke down. “I have to get out of here. I have to go home and use drugs.”
She had used fentanyl before arriving at the hospital and had sufficient opportunity to get treated before she had to return to get high again. She thought she still had several weeks to find a way to become sober and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the leg infection was serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.
Five days later, on the 12th of November, Stephanie delivered a baby girl weighing 4lb 8oz – premature, small but alive.
When the nurse asked if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been administered a few hours prior to birth.
She felt unwell. Not ready for motherhood. Not fit.
Stephanie had sought recovery several times during pregnancy, and felt awful each time she relapsed. She felt worthless, berating herself for not being able to achieve the unattainable. An OBGYN told her to “just” stop using. Even her source would not provide to her when she became clearly expecting.
“Yet I was unable,” she said. “I needed help.”
The widespread belief that her love for her baby would make her quit only led to increased guilt and self-abuse, a impetus for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The baby was taken to the NICU. When Stephanie finally saw her her, she was attached to monitors, so tiny she thought she would break her. Holding her for the first time, she felt empty. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Two days later she decided to call her daughter Izzie, after the professional who provided support to her.
Medical personnel told her about Maddie’s Place, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still rushed to special care and medicated while their mothers face custody evaluations. But a limited but expanding group of centers like Maddie’s Place is proving a simple point: when mothers and babies stay together, outcomes improve, foster placements fall and future expenses reduce.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in detox, fearful and unsure about what would happen next.
At the facility, Stephanie still worried that CPS would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any moment, someone could arrive and take her baby away.
For the initial fortnight, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about getting by. Drugs came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to hurt her. She lacked the ability to care for herself, let alone anyone else.
Every day, staff from the center took her to a clinic for methadone, provided orally. Gradually, she was embracing sobriety.
She devoted all her time when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed dietary support. She also had increased sensitivity and required an professional – all frequent conditions for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I could do this. I could parent.
On a day prior to the holiday, Stephanie sat in the visitation area, where individuals struggling with substance use can come for guided meetings with their babies. A support specialist, a peer support specialist, came over with her own family in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She keeps a photo of the moment. She is dressed in casual attire, a beanie with a pompom on her head, seated on the ground with the exit nearby. She is slender. Her head is tilted forward so you miss her features. She is lifting the baby on her lap for the other kids to see and they are standing close, admiring and touching to the baby.
A young boy, eight, asked the parents: “What about the fathers?” The women attempted to clarify that the fathers had obligations, called away to other tasks, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I found the courage. I would become a mother.”
Approaches for managing drug-exposed newborns have existed for decades.
The Finnegan NAS scale was developed in 1975|
