She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Transformed Their Futures.
Pregnant and experiencing intense discomfort, the expectant mother visited the medical facility after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had built in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. Withdrawal was setting in. She slumped forward and threw up.
Stephanie finally broke down. “I have to get out of here. I have to go home and take a hit.”
She had consumed opioids before arriving at the hospital and had sufficient opportunity to get treated before she was compelled to leave to use once more. She thought she still had four weeks left to find a way to become sober and give birth.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the leg infection was severe, but medical staff detected she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she departed, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be transitioned to methadone, a medication that eases withdrawal and is often prescribed in substance abuse treatment.
After five days, on the 12th of November, Stephanie delivered a baby girl weighing 4lb 8oz – early, tiny yet healthy.
When the nurse asked if she wanted to hold her baby, Stephanie said “I cannot.” She was detached. Her pain relief did not work, her last dose of fentanyl had been administered shortly before she gave birth.
She felt unwell. Unprepared to be a mother. Undeserving.
Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she relapsed. She felt without value, criticizing herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her supplier declined to supply to her when she became obviously with child.
“However, I failed,” she said. “I had to seek support.”
The pervasive expectation that her love for her baby would make her stop using only led to deeper self-loathing and negative self-talk, a cause for her to relapse. Yet she could not easily command her addiction away, any more than she could eliminate a long-term illness.
The newborn was transferred to the special care nursery. When Stephanie at last met her, she was hooked up to medical equipment, so tiny she thought she would hurt her. Cradling her initially, she felt nothing. “I just stared at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to name her baby Izzie, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a innovative treatment home where women and their babies are treated together, not apart.
In much of the US, where a baby is diagnosed with newborn addiction symptoms every 18 minutes, infants are still whisked to NICUs and given drugs while their mothers face child-protection investigations. But a limited but expanding group of centers like Maddie’s Place is demonstrating a key fact: when parents and infants remain united, results get better, foster placements fall and future expenses reduce.
It took Stephanie some time to build confidence to call, but she finally did. After confirming she would be a good fit for the program, care providers came to collect her.
She left the medical center still in recovery, fearful and unsure about what would happen next.
At the care center, Stephanie still worried that authorities would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could arrive and separate them.
For the initial fortnight, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about getting by. Substances came first; reliance came last.
Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to cause pain. She lacked the ability to value herself, let alone anyone else.
Daily, staff from the facility drove her to a treatment center, administered in pill form. Gradually, she was beginning recovery.
She devoted all her time outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed feeding therapy. She also had increased sensitivity and required an occupational therapist – all frequent conditions for babies born with NAS.
Seeing that even a young person understands the need for care, then I found the strength. I could parent.
On a day prior to the holiday, Stephanie remained in the shared space, where those still using can come for guided meetings with their babies. Katie Bunch-Smith, a recovery coach, visited with her own family in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She keeps a photo of the moment. She is dressed in black pants and a hoodie, a beanie with a decoration on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her face is downcast so you cannot see her face. She is presenting her daughter on her lap for the children to see and they are standing close, admiring and touching to the baby.
A young boy, eight, asked the mothers: “Where are all the dads?” The moms tried to explain that the fathers had obligations, called away to other tasks, that they would be there given the chance.
“In the future,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I found the courage. I could be a mom.”
Tools for treating infants affected by substances have been used for a long time.
The Finnegan NAS scale was created in 1975|
