She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the hospital emergency room after a serious infection started to spread up her legs. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had assembled in a friend’s yard. She was also hooked on fentanyl.
As medical staff managed her infection, she started to feel anxious. The onset of withdrawal began. She slumped forward and threw up.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had consumed opioids before arriving at the hospital and had sufficient opportunity to get treated before she had to return to relapse. She thought she still had a month remaining to find a way to become sober and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but physicians found she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she walked out, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a drug that alleviates cravings and is commonly used in substance abuse treatment.
A short time later, on the 12th of November, Stephanie delivered a daughter weighing just over four pounds – born before term, little but surviving.
When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been provided a few hours prior to birth.
She felt ill. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she relapsed. She felt hopeless, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “just” stop using. Even her source declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I required assistance.”
The common assumption that her affection for her child would make her quit only led to greater shame and self-abuse, a impetus for her to relapse. Yet she could not easily command her addiction away, any more than she could eliminate a chronic disease.
The baby was taken to the special care nursery. When Stephanie at last met her, she was connected to tubes and leads, so small she thought she would harm her. Embracing her at last, she felt empty. “I gazed upon her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to call her daughter the same as her nurse, after the attendant who showed compassion to her.
Medical personnel told her about Maddie’s Place, a innovative treatment home where women and their babies are cared for jointly, not apart.
In many parts of America, where a baby is identified with infant withdrawal condition every 18 minutes, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face parental assessments. But a developing system of centers like the care home is demonstrating a key fact: when families are kept intact, results get better, 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, a couple of employees came to bring her to the facility.
She departed the institution still in recovery, anxious and doubtful about what would come next.
At Maddie’s Place, Stephanie still feared that authorities would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could walk in and take her baby away.
For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about enduring. Addiction came first; reliance came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to let her down. She did not know how to care for herself, not to mention anyone else.
Every day, staff from the center transported her to a recovery program, provided orally. Over time, she was starting to get clean.
She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and obvious stomach troubles. She needed feeding therapy. She also had sensory challenges and required an professional – all typical problems for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a peer support specialist, visited with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She keeps a photo of the moment. She is clad in dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, resting on the floor with the entryway at her back. She is lean. Her posture is humble so you cannot see her face. She is presenting her daughter on her knee for the children to see and they are crowding near, showing interest to the baby.
A young boy, eight, asked the moms: “Where are all the dads?” The moms tried to explain that the men were occupied, handling responsibilities, 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 her companion made eye contact. “I broke down,” Stephanie said. “If this little kid could see that newborns require care, then I found the courage. I would become a mother.”
Methods to address infants affected by substances have been used for a long time.
The assessment tool was created in 1975|
