Fentanyl Addiction During Pregnancy: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the ER after her infection worsened up her legs. Jobless and without shelter, estranged from her family, she stayed in a makeshift shelter she had constructed in a friend’s yard. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie finally broke down. “I need to leave. I have to go home and take a hit.”
She had taken the drug before coming to the ER and had sufficient opportunity 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 deliver her child.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was serious, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be transitioned to methadone, a medication that eases withdrawal and is often prescribed in addiction recovery.
Five days later, on a day in November 2022, Stephanie gave birth to a daughter weighing just over four pounds – premature, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt sick. Not ready for motherhood. Unworthy.
Stephanie had tried to get clean several times during pregnancy, and felt terrible each time she relapsed. She felt hopeless, blaming herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her supplier would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The widespread belief that her affection for her child would make her quit only led to increased guilt and self-harm, a cause for her to relapse. Yet she could not just wish her addiction away, any more than she could eliminate a chronic disease.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was connected to tubes and leads, so tiny she thought she would harm her. Embracing her at last, she felt nothing. “I looked at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to name her baby Izzie, after the attendant who showed compassion to her.
Nurses and doctors told her about Maddie’s Place, a innovative treatment home where women and their babies are treated together, not apart.
In numerous states, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is proving a simple point: when families are kept intact, results get better, fewer children enter care and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After verifying her eligibility for the program, two staff members came to pick her up.
She left the medical center still in withdrawal, fearful and unsure about what would happen next.
At the facility, Stephanie still worried that CPS would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any moment, someone could walk in and separate them.
For the beginning period, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Substances came first; faith came last.
Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to hurt her. She lacked the ability to love herself, much less anyone else.
Each day, staff from the facility drove her to a recovery program, given as medication. 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 girl had some trouble feeding at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed dietary support. She also had increased sensitivity 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 would become a mother.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for guided meetings with their babies. A support specialist, a recovery coach, visited with her own children in tow to deliver baked goods. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She keeps a photo of the moment. She is dressed in casual attire, a cap with a pompom on her head, resting on the floor with the door behind her. She is lean. Her face is downcast so you cannot see her face. She is holding Izzie up on her lap for the other kids to see and they are standing close, admiring and touching to the baby.
A young boy, eight, asked the moms: “Why are there no men?” The moms tried to explain that the dads were busy, handling responsibilities, that they would be there given the chance.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I just lost it and fell apart,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I would become a mother.”
Approaches for managing infants affected by substances have been used for a long time.
The Finnegan NAS scale was established in 1975|