Fentanyl Addiction During Pregnancy: Choosing Motherhood Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother visited the medical facility after an infection began spreading up her legs. Unemployed and homeless, separated from loved ones, she stayed in a makeshift shelter she had assembled in a companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and threw up.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”
She had consumed opioids before seeking medical help and had just enough time to get treated before she had to return to relapse. She thought she still had four weeks left to find a way to become sober and deliver her child.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in substance abuse treatment.
Five days later, on the 12th of November, Stephanie delivered a daughter weighing a small weight – early, tiny yet healthy.
When the attendant inquired if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her epidural had failed, her final administration of fentanyl had been provided four hours before delivery.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she failed. She felt without value, berating herself for not being able to overcome the challenge. An obstetrician told her to “just” stop using. Even her supplier refused to sell to her when she became obviously with child.
“Yet I was unable,” she said. “I required assistance.”
The common assumption that her love for her baby would make her recover only led to deeper self-loathing and self-abuse, a impetus for her to return to drugs. Yet she could not easily command her addiction away, any more than she could will away a persistent condition.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was connected to medical equipment, so small she thought she would harm her. Embracing her at last, she felt empty. “I looked at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to call her daughter Izzie, after the professional who provided support to her.
Nurses and doctors told her about Maddie’s Place, a innovative treatment home where women and their babies are supported as a unit, not apart.
In much of the US, where a baby is found to have neonatal abstinence syndrome (NAS) every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like the care home is showing an important truth: when parents and infants remain united, recovery succeeds, custody cases decrease and overall savings increase.
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 departed the institution still in withdrawal, anxious and doubtful about what would happen next.
At Maddie’s Place, Stephanie still feared that CPS would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any time, someone could walk in and separate them.
For the initial fortnight, Stephanie remained isolated. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about getting by. Drugs came first; reliance came last.
Stephanie had a trusted ally, but even that relationship was delicate. The people she loved always found ways to hurt her. She was unable to love herself, let alone anyone else.
Daily, staff from Maddie’s Place transported her to a treatment center, provided orally. Over time, she was embracing sobriety.
She devoted all her time beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and obvious stomach troubles. She needed nutritional guidance. 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.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where individuals struggling with substance use can come for monitored interactions with their babies. An advocate, a peer support specialist, came over with her own five kids in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in wonder of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She holds a picture of the moment. She is clad in black pants and a hoodie, a gray knit hat with a decoration on her head, resting on the floor with the exit nearby. She is slender. Her head is tilted forward so you miss her features. She is presenting her daughter on her leg for the children to see and they are gathered around, showing interest to the baby.
One child, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the men were occupied, handling responsibilities, 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 made eye contact. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that infants need affection, then I was able. I could parent.”
Tools for treating drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was created in 1975|
