Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother visited the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, estranged from her family, she lived in a shed she had assembled in a friend’s yard. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and vomited.
Stephanie finally broke down. “I have to get out of here. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had sufficient opportunity to get treated before she needed to go home to relapse. She thought she still had four weeks left to figure out how to get clean and give birth.
The medical professional intervened. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was critical, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a treatment that reduces symptoms and is often prescribed in addiction recovery.
Five days later, on a day in November 2022, Stephanie gave birth to a infant weighing a small weight – premature, little but surviving.
When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been administered a few hours prior to birth.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had sought recovery repeatedly before birth, and felt terrible each time she failed. She felt hopeless, blaming herself for not being able to do the impossible. An OBGYN told her to “simply” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“However, I failed,” she said. “I had to seek support.”
The common assumption that her affection for her child would make her quit only led to increased guilt and self-abuse, a trigger for her to use again. Yet she could not simply will her addiction away, any more than she could overcome a long-term illness.
The infant was moved to the NICU. When Stephanie at last met her, she was connected to monitors, so little she thought she would break her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to call her daughter after her caregiver, after the professional who provided support to her.
Hospital staff told her about Maddie’s Place, a unique recovery environment where women and their babies are cared for jointly, not apart.
In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) frequently, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a limited but expanding group of centers like this facility is showing an important truth: when parents and infants remain united, recovery succeeds, custody cases decrease and future expenses reduce.
It took Stephanie some time to build confidence to call, but she eventually made the call. After ensuring she qualified for the program, two staff members came to pick her up.
She left the medical center still in recovery, anxious and doubtful about what would follow.
At the facility, Stephanie still was concerned that child services would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any point, someone could arrive and take her baby away.
For the first two weeks, Stephanie stayed withdrawn. “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 survival. Drugs came first; reliance came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to cause pain. She was unable to value herself, let alone anyone else.
Daily, staff from the center took her to a treatment center, given as medication. Gradually, she was beginning recovery.
She devoted all her time 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 intolerance to some formulas and severe digestive problems. She needed dietary support. She also had increased sensitivity and required an specialist – all common issues for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I was capable. I could parent.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a mentor, stopped by with her own family in tow to bring treats. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The young ones stared in wonder of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She has an image of the moment. She is dressed in dark trousers and a sweatshirt, a cap with a pompom on her head, seated on the ground with the entryway at her back. She is thin. Her posture is humble so you cannot see her face. She is lifting the baby on her knee for the young ones to see and they are crowding near, showing interest to the baby.
Jacob, eight, asked the mothers: “Why are there no men?” The women attempted to clarify that the fathers had obligations, engaged elsewhere, 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 her companion looked at each other. “I broke down,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I found the courage. I would become a mother.”
Approaches for managing babies with exposure have existed for decades.
The assessment tool was established in 1975|
