She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
In her eighth month of pregnancy and suffering, the expectant mother arrived at the medical facility after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had built in a acquaintance's garden. She was also hooked on fentanyl.
As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She slumped forward and threw up.
Stephanie ultimately gave in. “I need to leave. I have to go home and take a hit.”
She had used fentanyl before arriving at the hospital and had just enough time to get treated before she had to return to get high again. She thought she still had several weeks to figure out how to get clean and give birth.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was serious, but physicians found she also had an leakage of amniotic fluid. 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 withdrawal could endanger her and the baby. Post-birth Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in substance abuse treatment.
After five days, on the 12th of November, Stephanie had a infant weighing just over four pounds – born before term, tiny yet healthy.
When the caregiver questioned 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 provided shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she relapsed. She felt hopeless, criticizing herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her supplier refused to sell to her when she became clearly expecting.
“However, I failed,” she said. “I needed help.”
The widespread belief that her love for her baby would make her stop using only led to deeper self-loathing and self-abuse, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The baby was taken to the NICU. When Stephanie finally saw her her, she was connected to monitors, so little she thought she would harm her. Cradling her initially, she felt empty. “I looked at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to name her baby the same as her nurse, after the nurse who had been so kind 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 infant withdrawal condition frequently, infants are still rushed to special care 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, recovery succeeds, foster placements fall and long-term costs decline.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility for the program, care providers came to collect her.
She stepped out of the hospital still in recovery, scared and uncertain about what would come next.
At Maddie’s Place, Stephanie still feared that child services would come remove her daughter – even though she was not sure she wanted to keep her. The fear lingered: that at any time, someone could arrive and separate them.
For the beginning period, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about survival. Drugs came first; reliance came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to cause pain. She lacked the ability to care for herself, not to mention anyone else.
Each day, staff from the center drove her to a clinic for methadone, administered in pill form. Gradually, she was embracing sobriety.
She devoted all her time when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and obvious stomach troubles. She needed dietary support. She also had heightened sensory issues 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 could do this. I would become a mother.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for guided meetings with their babies. Katie Bunch-Smith, a peer support specialist, stopped by with her own family in tow to drop off cookies. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in wonder of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a pompom on her head, sitting on the wooden floor with the door behind her. She is lean. Her head is tilted forward so you cannot see her face. She is presenting her daughter on her leg for the other kids to see and they are crowding near, fawning and reaching out to the baby.
Jacob, eight, asked the parents: “Where are all the dads?” The women attempted to clarify that the dads were busy, called away to other tasks, that they would be there if they could.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith made eye contact. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I was able. I would become a mother.”
Approaches for managing babies with exposure have been used for a long time.
The evaluation method was created in 1975|
