She Was Pregnant and Addicted to Fentanyl: 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. Without a job or home, cut off from her relatives, she stayed in a makeshift shelter she had built in a friend’s yard. She was also addicted to fentanyl.
As physicians addressed her infection, she started to feel anxious. Withdrawal was setting in. She bent over the bedside and vomited.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and get high.”
She had used fentanyl before seeking medical help and had just enough time to get treated before she had to return to use once more. She thought she still had several weeks to figure out how to get clean and have this baby.
The medical professional intervened. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the leg infection was serious, 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 controlled doses of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is frequently utilized in rehabilitation.
Five days later, on the 12th of November, Stephanie delivered a baby girl weighing just over four pounds – born before term, little but surviving.
When the attendant inquired if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her epidural had failed, her last dose of fentanyl had been given four hours before delivery.
She felt ill. Ill-equipped for parenting. Undeserving.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she failed. She felt worthless, berating herself for not being able to do the impossible. An doctor told her to “simply” stop using. Even her source declined to supply to her when she became obviously with child.
“However, I failed,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her recover only led to increased guilt and self-harm, a impetus for her to return to drugs. Yet she could not just wish her addiction away, any more than she could will away a persistent condition.
The newborn was transferred to the NICU. When Stephanie eventually visited her, she was hooked up to monitors, so small she thought she would break her. Cradling her initially, she felt empty. “I gazed upon her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to give her child the name 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 mothers and their drug-exposed newborns are treated together, not apart.
In many parts of America, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a developing system of centers like this facility is proving a simple point: when mothers and babies stay together, outcomes improve, fewer children enter care and long-term costs decline.
It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to bring her to the facility.
She left the medical center still in detox, scared and uncertain about what would happen next.
At the facility, Stephanie still worried that CPS would come take Izzie – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could enter and separate them.
For the first two weeks, Stephanie remained isolated. “I preferred to be alone,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about getting by. 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 lacked the ability to care for herself, much less anyone else.
Daily, staff from Maddie’s Place transported her to a clinic for methadone, provided orally. Over time, she was starting to get clean.
She devoted all her time outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and obvious stomach troubles. She needed nutritional guidance. She also had sensory challenges and required an occupational therapist – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I was capable. I could parent.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for supervised visits with their babies. An advocate, a recovery coach, came over with her own family in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She keeps a photo of the moment. She is clad in dark trousers and a sweatshirt, a cap with a bobble on her head, resting on the floor with the exit nearby. She is slender. Her face is downcast so you do not see her expression. She is presenting her daughter on her leg for the young ones to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the moms: “Why are there no men?” The parents responded that the men were occupied, called away to other tasks, that they would be there given the chance.
“In the future,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that infants need affection, then I was able. I could be a mom.”
Tools for treating drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was established in 1975|
