Fentanyl Addiction During Pregnancy: Choosing Motherhood Transformed Their Futures.
In her eighth month of pregnancy and suffering, the expectant mother went to the hospital emergency room after a serious infection started to spread up her legs. Without a job or home, separated from loved ones, she resided in a small structure she had assembled in a acquaintance's garden. She was also hooked on fentanyl.
As medical staff managed her infection, she began to panic. The onset of withdrawal began. She slumped forward and became sick.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and take a hit.”
She had consumed opioids 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 several weeks to plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was critical, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she walked out, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in rehabilitation.
After five days, on a day in November 2022, Stephanie had a daughter weighing a small weight – born before term, small but alive.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her epidural had failed, her previous intake of fentanyl had been given a few hours prior to birth.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she was unsuccessful. She felt hopeless, criticizing herself for not being able to do the impossible. An doctor told her to “simply” stop using. Even her supplier would not provide to her when she became visibly pregnant.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her stop using only led to greater shame and negative self-talk, a impetus for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.
The newborn was transferred to the neonatal intensive care unit. When Stephanie eventually visited her, she was hooked up to medical equipment, so small she thought she would harm 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.
Following a brief period she decided to name her baby the same as her nurse, after the professional who provided support to her.
Nurses and doctors told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a developing system of centers like the care home is showing an important truth: when parents and infants remain united, outcomes improve, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, care providers came to pick her up.
She left the medical center still in withdrawal, scared and uncertain about what would come next.
At the care center, Stephanie still was concerned that CPS would come remove her daughter – even though she was uncertain about motherhood. The concern persisted: that at any time, someone could enter and separate them.
For the beginning period, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about enduring. Substances came first; trust came last.
Stephanie had one close friend, but even that relationship was delicate. The those close to her always found ways to cause pain. She did not know how to value herself, not to mention anyone else.
Daily, staff from Maddie’s Place drove her to a treatment center, administered in pill form. Slowly, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and severe digestive problems. She needed dietary support. She also had increased sensitivity and required an professional – all typical problems for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I was capable. I could be a mom.
On a day prior to the holiday, Stephanie remained in the shared space, where those still using can come for monitored interactions with their babies. A support specialist, a peer support specialist, visited with her own children in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She holds a picture of the moment. She is wearing dark trousers and a sweatshirt, a cap with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her posture is humble so you do not see her expression. She is lifting the baby on her leg for the young ones to see and they are crowding near, showing interest to the baby.
One child, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the fathers had obligations, engaged elsewhere, that they would be there if possible.
“In the future,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion made eye contact. “I broke down,” Stephanie said. “If this little kid could see that infants need affection, then I found the courage. I could parent.”
Tools for treating infants affected by substances have existed for decades.
The evaluation method was created in 1975|
