Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
Eight months pregnant and in severe pain, the expectant mother went to the medical facility after a serious infection started to spread up her legs. Jobless and without shelter, estranged from her family, she resided in a small structure she had constructed in a acquaintance's garden. She was also addicted to fentanyl.
As medical staff managed her infection, she began to panic. The onset of withdrawal began. She slumped forward and threw up.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had only a brief window to get treated before she had to return to use once more. She thought she still had four weeks left to plan her recovery and deliver her child.
The nurse had other ideas. 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 severe, but doctors had discovered she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she walked out, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is often prescribed in substance abuse treatment.
After five days, on 12 November 2022, Stephanie gave birth to a infant weighing just over four pounds – early, tiny yet healthy.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was emotionless. Her pain relief did not work, her final administration of fentanyl had been provided shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she failed. She felt without value, blaming herself for not being able to do the impossible. An OBGYN 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 needed help.”
The widespread belief that her bond with her newborn would make her stop using only led to increased guilt and negative self-talk, a trigger for her to use again. Yet she could not just wish her addiction away, any more than she could eliminate a long-term illness.
The infant was moved to the NICU. When Stephanie finally saw her her, she was connected to tubes and leads, so little she thought she would harm her. Embracing her at last, she felt nothing. “I just stared at her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to call her daughter Izzie, after the attendant who showed compassion to her.
Medical personnel told her about a specialized facility, 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 diagnosed with newborn addiction symptoms frequently, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a small, growing network of centers like this facility is showing an important truth: when families are kept intact, outcomes improve, 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, a couple of employees came to bring her to the facility.
She stepped out of the hospital still in withdrawal, fearful and unsure about what would come next.
At the care center, Stephanie still was concerned that child services would come take Izzie – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could walk in and separate them.
For the initial fortnight, Stephanie stayed withdrawn. “I avoided interaction,” 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 bond was fragile. The individuals she cared for always found ways to cause pain. She did not know how to care for herself, much less anyone else.
Every day, staff from the facility transported her to a treatment center, given as medication. Slowly, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with adverse reactions to milk and severe digestive problems. She needed nutritional guidance. She also had heightened sensory issues and required an specialist – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I would become a mother.
On a day prior to the holiday, Stephanie was in the common room, 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 children in tow to deliver baked goods. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is dressed in black pants and a hoodie, a cap with a bobble on her head, seated on the ground with the entryway at her back. She is lean. Her posture is humble so you miss her features. She is holding Izzie up on her knee for the other kids to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the moms: “Why are there no men?” The women attempted to clarify that the men were occupied, handling responsibilities, that they would be there given the chance.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and the specialist made eye contact. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I found the courage. I could parent.”
Methods to address babies with exposure have been available for years.
The Finnegan NAS scale was established in 1975|
