She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother went to the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had built in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she started to feel anxious. Withdrawal was setting in. She bent over the bedside and vomited.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had used fentanyl before seeking medical help and had just enough time to get treated before she was compelled to leave to relapse. She thought she still had a month remaining to plan her recovery and deliver her child.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she departed, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
After five days, on the 12th of November, Stephanie delivered a daughter weighing a small weight – premature, tiny yet healthy.
When the attendant inquired 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 given a few hours prior to birth.
She felt unwell. Not ready for motherhood. Not fit.
Stephanie had tried to get clean repeatedly before birth, and felt awful 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 supplier declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I had to seek support.”
The common assumption that her bond with her newborn would make her quit only led to greater shame and negative self-talk, a impetus for her to use again. Yet she could not simply will her addiction away, any more than she could will away a long-term illness.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was connected to medical equipment, so little she thought she would break her. Holding her for the first time, she felt detached. “I just stared at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to call her daughter Izzie, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a new kind of care center where women and their babies are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still quickly moved to hospitals and medicated while their mothers face parental assessments. But a limited but expanding group of centers like the care home is proving a simple point: when mothers and babies stay together, recovery succeeds, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength to call, but she ultimately reached out. After confirming she would be a good fit for the program, two staff members came to pick her up.
She departed the institution still in detox, scared and uncertain about what would happen next.
At the facility, Stephanie still worried that child services would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any point, someone could arrive 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 was suspicious at that point.”
Survival outdoors, she said, was about survival. Substances came first; trust came last.
Stephanie had a trusted ally, but even that connection was tenuous. The people she loved always found ways to let her down. She lacked the ability to love herself, let alone anyone else.
Each day, staff from the center transported her to a treatment center, given as medication. Gradually, she was embracing sobriety.
She devoted all her time beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed dietary support. She also had heightened sensory issues and required an professional – all frequent conditions for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I was capable. I could be a mom.
On a day prior to the holiday, Stephanie sat in the visitation area, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a mentor, came over with her own family in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet 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. “My past did not matter to them. They focused only on the baby.”
She holds a picture of the moment. She is clad in black pants and a hoodie, a gray knit hat with a decoration on her head, seated on the ground with the door behind her. She is slender. Her posture is humble so you miss her features. 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 parents: “What about the fathers?” The parents responded that the fathers had obligations, handling responsibilities, that they would be there if possible.
“In the future,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist made eye contact. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that newborns require care, then I was able. I would become a mother.”
Approaches for managing drug-exposed newborns have been available for years.
The assessment tool was created in 1975|