She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
Eight months pregnant and in severe pain, a woman named Stephanie went to the hospital emergency room after an infection began spreading up her legs. Unemployed and homeless, cut off from her relatives, she lived in a shed she had constructed in a acquaintance's garden. She was also hooked on fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She slumped forward and vomited.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and take a hit.”
She had used fentanyl before coming to the ER and had sufficient opportunity to get treated before she was compelled to leave to use once more. She thought she still had four weeks left 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 doctors would not let her go: the leg infection was severe, but medical staff detected she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she departed, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in substance abuse treatment.
After five days, on the 12th of November, Stephanie had a daughter weighing just over four pounds – premature, tiny yet healthy.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was numb. Her epidural had failed, her previous intake of fentanyl had been administered four hours before delivery.
She felt unwell. Unprepared to be a mother. Not fit.
Stephanie had sought recovery several times during pregnancy, and felt terrible each time she was unsuccessful. She felt without value, criticizing herself for not being able to do the impossible. An doctor told her to “just” stop using. Even her source refused to sell to her when she became visibly pregnant.
“However, I failed,” she said. “I needed help.”
The common assumption that her affection for her child would make her quit only led to deeper self-loathing and negative self-talk, a cause for her to use again. Yet she could not simply will her addiction away, any more than she could eliminate a long-term illness.
The baby was taken to the NICU. When Stephanie at last met her, she was hooked up to tubes and leads, so little she thought she would hurt her. Holding her for the first time, 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 call her daughter the same as her nurse, after the nurse who had been so kind to her.
Nurses and doctors told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are treated together, not apart.
In much of the US, where a baby is identified with infant withdrawal condition every 18 minutes, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a developing system of centers like this facility is showing an important truth: when parents and infants remain united, results get better, foster placements fall and future expenses reduce.
It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, two staff members came to collect her.
She stepped out of the hospital still in withdrawal, scared and uncertain about what would follow.
At Maddie’s Place, Stephanie still feared that authorities would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any moment, someone could enter and remove her child.
For the initial fortnight, Stephanie remained isolated. “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.”
Life on the streets, she said, was about enduring. Addiction came first; trust came last.
Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to hurt her. She lacked the ability to care for herself, much less anyone else.
Every day, staff from Maddie’s Place took her to a recovery program, administered in pill form. Over time, she was starting to get clean.
She spent every minute when not in sessions 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 severe digestive problems. She needed nutritional guidance. She also had increased sensitivity and required an specialist – all typical problems for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could be a mom.
On a day prior to the holiday, Stephanie was in the common room, where those still using can come for supervised visits with their babies. Katie Bunch-Smith, a recovery coach, came over with her own five kids in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She has an image of the moment. She is dressed in black pants and a hoodie, a cap with a pompom on her head, seated on the ground with the exit nearby. She is lean. Her face is downcast so you miss her features. She is holding Izzie up on her lap for the young ones to see and they are gathered around, admiring and touching to the baby.
Jacob, eight, asked the moms: “Why are there no men?” 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 plan to be a great parent. I will teach them about love.”
Stephanie and her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I could do this. I would become a mother.”
Methods to address drug-exposed newborns have been available for years.
The evaluation method was created in 1975|
