She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Transformed Their Futures.
In her eighth month of pregnancy and suffering, the expectant mother arrived at the hospital emergency room 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 acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. Symptoms of withdrawal emerged. She slumped forward and became sick.
Stephanie finally broke down. “I have to get out of here. I have to go home and use drugs.”
She had used fentanyl before arriving at the hospital and had only a brief window to get treated before she was compelled to leave to get high again. She thought she still had four weeks left to plan her recovery and give birth.
The attending nurse disagreed. 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 serious, but medical staff detected she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in rehabilitation.
After five days, on the 12th of November, Stephanie gave birth to a infant weighing 4lb 8oz – early, little but surviving.
When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was detached. Her anesthesia was ineffective, her last dose of fentanyl had been provided four hours before delivery.
She felt unwell. Ill-equipped for parenting. Unworthy.
Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she relapsed. She felt hopeless, criticizing herself for not being able to achieve the unattainable. An obstetrician told her to “just” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“But I couldn’t,” she said. “I needed help.”
The widespread belief that her affection for her child would make her quit only led to greater shame and self-harm, a trigger for her to relapse. Yet she could not simply will her addiction away, any more than she could overcome 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 break her. Cradling her initially, she felt detached. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to call her daughter the same as her nurse, after the professional who provided support to her.
Medical personnel told her about Maddie’s Place, a new kind of care center where parents and infants affected by substance use are supported as a unit, not apart.
In numerous states, where a baby is identified with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a limited but expanding group of centers like this facility is proving a simple point: when parents and infants remain united, recovery succeeds, fewer children enter care and future expenses reduce.
It took Stephanie a period to find strength to call, but she finally did. After verifying her eligibility for the program, two staff members came to collect her.
She left the medical center still in withdrawal, fearful and unsure about what would follow.
At the care center, Stephanie still feared that child services would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could enter and remove her child.
For the initial fortnight, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about survival. Drugs came first; reliance came last.
Stephanie had a single companion, but even that connection was tenuous. The people she loved always found ways to let her down. She lacked the ability to care for herself, much less anyone else.
Every day, staff from the facility took her to a clinic for methadone, given as medication. Gradually, she was beginning recovery.
She utilized each moment when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with adverse reactions to milk and obvious stomach troubles. She needed nutritional guidance. She also had heightened sensory issues and required an professional – all typical problems for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
During a pre-holiday visit, Stephanie was in the common room, where parents in active addiction can come for monitored interactions with their babies. A support specialist, a recovery coach, came over with her own family in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in wonder of the small baby 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 holds a picture of the moment. She is clad in casual attire, a beanie with a bobble on her head, sitting on the wooden floor with the door behind her. She is thin. Her head is tilted forward so you do not see her expression. She is lifting the baby on her knee for the children to see and they are standing close, fawning and reaching out to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The parents responded that the fathers had obligations, engaged elsewhere, that they would be there if they could.
“Once I become a parent,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and the specialist exchanged glances. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I could do this. I could parent.”
Methods to address babies with exposure have been available for years.
The evaluation method was established in 1975|
