A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Transformed Their Futures.
Eight months pregnant and in severe pain, a woman named Stephanie arrived at the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had assembled in a companion's property. She was also addicted to fentanyl.
As physicians addressed her infection, she began to panic. The onset of withdrawal began. She slumped forward and threw up.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and get high.”
She had consumed opioids before coming to the ER and had just enough time to get treated before she needed to go home to relapse. 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 staying put.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the leg infection was severe, but doctors had discovered she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she left, 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. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in addiction recovery.
Five days later, on the 12th of November, Stephanie delivered a baby girl weighing just over four pounds – born before term, tiny yet healthy.
When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt ill. Unprepared to be a mother. Undeserving.
Stephanie had tried to get clean repeatedly before birth, and felt awful each time she failed. She felt without value, criticizing herself for not being able to achieve the unattainable. An OBGYN told her to “simply” stop using. Even her source declined to supply to her when she became clearly expecting.
“Yet I was unable,” she said. “I required assistance.”
The widespread belief that her affection for her child would make her recover only led to greater shame and self-harm, a cause for her to return to drugs. Yet she could not simply will her addiction away, any more than she could will away a chronic disease.
The newborn was transferred to the NICU. When Stephanie at last met her, she was hooked up to medical equipment, so small she thought she would harm her. Cradling her initially, she felt empty. “I gazed upon her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
After two days she decided to call her daughter Izzie, after the professional who provided support to her.
Hospital staff told her about a care center, a innovative treatment home where parents and infants affected by substance use are treated together, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face custody evaluations. But a limited but expanding group of centers like this facility is showing an important truth: when families are kept intact, results get better, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After verifying her eligibility for the program, a couple of employees came to pick her up.
She left the medical center still in withdrawal, anxious and doubtful about what would come next.
At the care center, Stephanie still worried that authorities would come remove her daughter – even though she was not sure she wanted to keep her. The fear lingered: that at any moment, someone could arrive and take her baby away.
For the beginning period, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Drugs came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to hurt her. She was unable to care for herself, let alone anyone else.
Daily, staff from the center drove her to a recovery program, given as medication. Gradually, she was embracing sobriety.
She utilized each moment 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 severe digestive problems. She needed dietary support. She also had sensory challenges and required an occupational therapist – all common issues for babies exposed to substances.
Seeing that even a young person understands the need for care, then I was capable. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. A support specialist, a recovery coach, visited with her own five kids in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The young ones stared in wonder of the tiny infant 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 has an image of the moment. She is wearing casual attire, a gray knit hat with a pompom on her head, sitting on the wooden floor with the door behind her. She is thin. Her face is downcast so you miss her features. She is holding Izzie up on her lap 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 dads were busy, engaged elsewhere, that they would be there if possible.
“When I have kids,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I could do this. I could parent.”
Approaches for managing drug-exposed newborns have been used for a long time.
The evaluation method was created in 1975|
