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 ER after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she lived in a shed she had constructed in a companion's property. She was also addicted to fentanyl.
As medical staff managed her infection, she began to panic. Withdrawal was setting in. She slumped forward and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and get high.”
She had used fentanyl before arriving at the hospital and had only a brief window to get treated before she had to return to relapse. She thought she still had a month remaining to figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but medical staff detected she also had an ruptured membrane. The nurse, her nurse, warned her: if she departed, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.
A short time later, on the 12th of November, Stephanie had a infant weighing 4lb 8oz – born before term, tiny yet healthy.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been given a few hours prior to birth.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she failed. She felt without value, berating herself for not being able to achieve the unattainable. An doctor told her to “just” stop using. Even her source declined to supply to her when she became clearly expecting.
“But I couldn’t,” she said. “I needed help.”
The pervasive expectation that her affection for her child would make her stop using only led to increased guilt and self-harm, a cause for her to return to drugs. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The newborn was transferred to the NICU. When Stephanie finally saw her her, she was hooked up to monitors, so small she thought she would break her. Embracing her at last, she felt empty. “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.
After two days she decided to call her daughter after her caregiver, after the nurse who had been so kind to her.
Medical personnel told her about Maddie’s Place, a innovative treatment home where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is identified with infant withdrawal condition every 18 minutes, infants are still rushed to special care and treated with pharmaceuticals while their mothers face parental assessments. But a developing system of centers like this facility is showing an important truth: when families are kept intact, outcomes improve, custody cases decrease and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After ensuring she qualified for the program, two staff members came to bring her to the facility.
She left the medical center still in detox, scared and uncertain about what would come next.
At Maddie’s Place, Stephanie still worried that child services would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could enter and take her baby away.
For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Substances came first; trust came last.
Stephanie had one close friend, but even that relationship was delicate. The those close to her always found ways to hurt her. She was unable to value herself, not to mention anyone else.
Each day, staff from Maddie’s Place took her to a recovery program, provided orally. Slowly, 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 infant faced feeding challenges at first, with intolerance to some formulas and severe digestive problems. She needed nutritional guidance. She also had heightened sensory issues and required an occupational therapist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
During a pre-holiday visit, Stephanie sat in the visitation area, where individuals struggling with substance use can come for guided meetings with their babies. A support specialist, a mentor, visited with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in wonder of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She holds a picture of the moment. She is clad in black pants and a hoodie, a cap with a pompom 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 leg for the other kids to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the mothers: “Where are all the dads?” The moms tried to explain that the men were occupied, called away to other tasks, that they would be there if possible.
“Once I become a parent,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I could do this. I could parent.”
Approaches for managing drug-exposed newborns have been available for years.
The Finnegan NAS scale was created in 1975|
