Fentanyl Addiction During Pregnancy: Choosing Motherhood Transformed Their Futures.
Eight months pregnant and in severe pain, the expectant mother visited the ER after her infection worsened up her legs. Unemployed and homeless, separated from loved ones, she lived in a shed she had assembled in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She leaned over the bed and vomited.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before arriving at the hospital and had only a brief window to get treated before she had to return to get high again. She thought she still had four weeks left to figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs 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.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is frequently utilized in addiction recovery.
Five days later, on a day in November 2022, Stephanie gave birth to a daughter weighing a small weight – born before term, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her epidural had failed, her last dose of fentanyl had been administered four hours before delivery.
She felt ill. Ill-equipped for parenting. Undeserving.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she relapsed. She felt without value, criticizing herself for not being able to overcome the challenge. An doctor told her to “only” stop using. Even her supplier declined to supply to her when she became obviously with child.
“However, I failed,” she said. “I required assistance.”
The common assumption that her bond with her newborn would make her stop using only led to increased guilt and negative self-talk, a trigger for her to return to drugs. Yet she could not simply will her addiction away, any more than she could will away a persistent condition.
The infant was moved to the neonatal intensive care unit. When Stephanie finally saw her her, she was attached to tubes and leads, so little she thought she would break her. Holding her for the first time, she felt empty. “I gazed upon her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Two days later she decided to name her baby the same as her nurse, after the professional who provided support to her.
Hospital staff told her about a specialized facility, a innovative treatment home where women and their babies are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a limited but expanding group of centers like this facility is demonstrating a key fact: when families are kept intact, recovery succeeds, foster placements fall and overall savings increase.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to pick her up.
She left the medical center still in recovery, fearful and unsure about what would follow.
At the care center, Stephanie still feared that CPS would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could enter and remove her child.
For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Drugs came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The individuals she cared for always found ways to cause pain. She was unable to value herself, not to mention anyone else.
Daily, staff from the facility transported her to a treatment center, provided orally. Gradually, she was starting to get clean.
She devoted all her time beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and obvious stomach troubles. She needed nutritional guidance. She also had heightened sensory issues and required an specialist – all frequent conditions for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I was capable. I could parent.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a mentor, 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 kids looked amazed in wonder of the small baby 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 casual attire, a cap with a decoration on her head, sitting on the wooden floor with the door behind her. She is slender. Her head is tilted forward so you do not see her expression. She is presenting her daughter on her lap for the other kids to see and they are crowding near, admiring and touching to the baby.
Jacob, eight, asked the moms: “What about the fathers?” The parents responded that the men were occupied, handling responsibilities, that they would be there given the chance.
“In the future,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
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.”
Approaches for managing infants affected by substances have existed for decades.
The assessment tool was created in 1975|
