A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
Pregnant and experiencing intense discomfort, a woman named Stephanie visited the hospital emergency room after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she lived in a shed she had assembled in a friend’s yard. She was also addicted to fentanyl.
As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. She slumped forward and vomited.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had used fentanyl before arriving at the hospital and had only a brief window to get treated before she was compelled to leave to relapse. She thought she still had four weeks left to plan her recovery and give birth.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was severe, but physicians found she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is often prescribed in rehabilitation.
Five days later, on the 12th of November, Stephanie delivered a daughter weighing just over four pounds – premature, tiny yet healthy.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her final administration of fentanyl had been provided four hours before delivery.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had tried to get clean several times during pregnancy, and felt terrible each time she failed. She felt without value, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her dealer would not provide to her when she became visibly pregnant.
“However, I failed,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her stop using only led to increased guilt and self-abuse, a impetus for her to return to drugs. Yet she could not just wish her addiction away, any more than she could overcome a chronic disease.
The infant was moved to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to monitors, so tiny she thought she would break her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
After two days she decided to give her child the name Izzie, after the nurse who had been so kind to her.
Medical personnel told her about a specialized facility, a new kind of care center where women and their babies are treated together, not apart.
In much of the US, where a baby is identified with infant withdrawal condition regularly, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a small, growing network of centers like this facility is showing an important truth: when families are kept intact, outcomes improve, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength to call, but she finally did. After confirming she would be a good fit for the program, a couple of employees came to collect her.
She left the medical center still in withdrawal, scared and uncertain about what would happen next.
At Maddie’s Place, Stephanie still feared that child services would come remove her daughter – even though she was hesitant about parenting. The concern persisted: that at any moment, someone could enter and take her baby away.
For the first two weeks, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about survival. 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 hurt her. She lacked the ability to care for herself, let alone anyone else.
Daily, staff from Maddie’s Place took her to a recovery program, administered in pill form. Gradually, she was beginning recovery.
She utilized each moment outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and severe digestive problems. She needed nutritional guidance. She also had heightened sensory issues and required an specialist – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. An advocate, a mentor, visited with her own five kids in tow to deliver baked goods. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in wonder of the little newborn 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 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 door behind her. She is lean. Her head is tilted forward so you miss her features. She is presenting her daughter on her leg for the children to see and they are standing close, admiring and touching to the baby.
Jacob, eight, asked the moms: “What about the fathers?” The parents responded that the men were occupied, handling responsibilities, that they would be there if possible.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and the specialist made eye contact. “I broke down,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I was able. I could be a mom.”
Methods to address infants affected by substances have been used for a long time.
The Finnegan NAS scale was created in 1975|
