A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the ER after an infection began spreading up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had assembled in a acquaintance's garden. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. The onset of withdrawal began. She slumped forward and vomited.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before seeking medical help and had only a brief window to get treated before she was compelled to leave to use once more. She thought she still had several weeks to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, a caregiver named 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 periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in rehabilitation.
After five days, on the 12th of November, Stephanie gave birth to a baby girl weighing a small weight – premature, tiny yet healthy.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was numb. Her epidural had failed, her final administration of fentanyl had been given shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she relapsed. She felt worthless, criticizing herself for not being able to do the impossible. An obstetrician told her to “just” stop using. Even her supplier refused to sell to her when she became obviously with child.
“However, I failed,” she said. “I needed help.”
The common assumption 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 just wish her addiction away, any more than she could will away a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie at last met her, she was attached to tubes and leads, so small she thought she would hurt her. Cradling her initially, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the attendant who showed compassion 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 supported as a unit, not apart.
In much of the US, where a baby is identified with infant withdrawal condition every 18 minutes, infants are still rushed to special care and given drugs while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, outcomes improve, fewer children enter care and overall savings increase.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After verifying her eligibility for the program, a couple of employees came to pick her up.
She stepped out of the hospital still in detox, scared and uncertain about what would come next.
At the facility, Stephanie still worried that authorities would come seize her child – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could arrive and remove her child.
For the first two weeks, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about enduring. Substances came first; reliance came last.
Stephanie had a single companion, but even that connection was tenuous. The those close to her always found ways to hurt her. She was unable to love herself, let alone anyone else.
Each day, staff from the center took her to a recovery program, administered in pill form. Over time, she was beginning recovery.
She utilized each moment 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 heightened sensory issues and required an occupational therapist – all common issues for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could parent.
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 recovery coach, stopped by with her own children in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in wonder of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She holds a picture 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 exit nearby. She is lean. Her face is downcast so you cannot see her face. She is holding Izzie up on her knee for the young ones to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The moms tried to explain that the fathers had obligations, engaged elsewhere, 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 the specialist looked at each other. “I broke down,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I was able. I would become a mother.”
Approaches for managing babies with exposure have been used for a long time.
The evaluation method was established in 1975|