She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Transformed Their Futures.
Eight months pregnant and in severe pain, a woman named Stephanie went to the hospital emergency room after her infection worsened up her legs. Without a job or home, cut off from her relatives, she stayed in a makeshift shelter she had assembled in a companion's property. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie finally broke down. “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 just enough time to get treated before she had to return to use once more. She thought she still had a month remaining to figure out how to get clean and deliver her child.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl every few hours, 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 rehabilitation.
Five days later, on the 12th of November, Stephanie delivered a daughter weighing 4lb 8oz – born before term, small but alive.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been administered shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Unworthy.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she was unsuccessful. She felt without value, berating herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her source declined to supply to her when she became clearly expecting.
“Yet I was unable,” she said. “I needed help.”
The common assumption that her love for her baby would make her recover only led to increased guilt and negative self-talk, a cause for her to relapse. Yet she could not easily command her addiction away, any more than she could will away a persistent condition.
The newborn was transferred to the NICU. When Stephanie eventually visited her, she was hooked up to tubes and leads, so small she thought she would hurt her. Cradling her initially, she felt detached. “I looked 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 call her daughter the same as her nurse, after the nurse who had been so kind to her.
Hospital staff told her about a care center, a innovative treatment home where parents and infants affected by substance use are supported as a unit, not apart.
In many parts of America, where a baby is diagnosed with infant withdrawal condition regularly, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a developing system of centers like the care home is demonstrating a key fact: when mothers and babies stay together, recovery succeeds, custody cases decrease and long-term costs decline.
It took Stephanie some time to build confidence to call, but she eventually made the call. After ensuring she qualified for the program, two staff members came to collect her.
She left the medical center still in recovery, scared and uncertain about what would follow.
At the facility, Stephanie still feared that child services would come take Izzie – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could walk in and separate them.
For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Drugs came first; faith 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.
Daily, staff from the facility took her to a recovery program, given as medication. Slowly, 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 infant faced feeding challenges at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an professional – all frequent conditions for babies exposed to substances.
Seeing that even a young person understands the need for care, then I found the strength. 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. An advocate, a mentor, visited with her own children in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She keeps a photo of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is lean. Her head is tilted forward so you miss her features. She is lifting the baby on her knee for the other kids to see and they are standing close, fawning and reaching out to the baby.
A young boy, eight, asked the mothers: “What about the fathers?” The women attempted to clarify that the men were occupied, called away to other tasks, that they would be there given the chance.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion made eye contact. “I became emotional,” Stephanie said. “Seeing that even youth understand that newborns require care, then I could do this. I would become a mother.”
Methods to address babies with exposure have been used for a long time.
The Finnegan NAS scale was developed in 1975|
