Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother went to the ER after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she lived in a shed she had constructed in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and threw up.
Stephanie ultimately gave in. “I need to leave. I have to go home and use drugs.”
She had taken the drug before seeking medical help and had sufficient opportunity to get treated before she was compelled to leave to relapse. She thought she still had four weeks left to find a way to become sober and have this baby.
The medical professional intervened. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but physicians found 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.
She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
After five days, on the 12th of November, Stephanie had a daughter weighing just over four pounds – born before term, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her pain relief did not work, her previous intake of fentanyl had been given shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Unworthy.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she failed. She felt hopeless, berating herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her source refused to sell to her when she became visibly pregnant.
“Yet I was unable,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her stop using only led to greater shame and self-harm, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could will away a chronic disease.
The baby was taken to the NICU. When Stephanie eventually visited her, she was attached to medical equipment, so little she thought she would break her. Embracing her at last, she felt nothing. “I just stared at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Two days later she decided to give her child the name Izzie, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition frequently, infants are still rushed to special care and given drugs while their mothers face custody evaluations. But a developing system of centers like the care home is demonstrating a key fact: when parents and infants remain united, outcomes improve, foster placements fall and long-term costs decline.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, two staff members came to pick her up.
She stepped out of the hospital still in recovery, fearful and unsure about what would follow.
At the facility, Stephanie still feared that child services would come seize her child – even though she was uncertain about motherhood. The fear lingered: that at any point, someone could arrive and separate them.
For the beginning period, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about getting by. Drugs came first; trust came last.
Stephanie had one close friend, but even that connection was tenuous. The individuals she cared for always found ways to cause pain. She did not know how to value herself, let alone anyone else.
Every day, staff from the center took her to a treatment center, provided orally. Over time, she was embracing sobriety.
She devoted all her time outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with adverse reactions to milk and obvious stomach troubles. She needed feeding therapy. She also had heightened sensory issues and required an specialist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I could do this. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a peer support specialist, came over with her own children in tow to deliver baked goods. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They had no care in the world,” 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 wearing dark trousers and a sweatshirt, a beanie with a decoration on her head, resting on the floor with the exit nearby. She is slender. Her posture is humble so you cannot see her face. She is lifting the baby on her knee for the children to see and they are crowding near, showing interest to the baby.
One child, eight, asked the mothers: “Why are there no men?” The parents responded that the fathers had obligations, called away to other tasks, that they would be there if possible.
“In the future,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and the specialist made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that infants need affection, then I could do this. I could parent.”
Tools for treating infants affected by substances have been used for a long time.
The evaluation method was created in 1975|
