She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother went to the ER after her infection worsened up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had constructed 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 threw up.
Stephanie eventually collapsed. “I need to leave. I have to go home and take a hit.”
She had consumed opioids before coming to the ER and had sufficient opportunity to get treated before she had to return to get high again. She thought she still had several weeks to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was serious, but physicians found she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is often prescribed in rehabilitation.
After five days, on the 12th of November, Stephanie gave birth to a baby girl weighing just over four pounds – born before term, tiny yet healthy.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been given four hours before delivery.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she was unsuccessful. She felt without value, blaming herself for not being able to achieve the unattainable. An doctor told her to “just” stop using. Even her supplier refused to sell to her when she became clearly expecting.
“However, I failed,” she said. “I required assistance.”
The pervasive expectation that her bond with her newborn would make her quit only led to increased guilt and self-abuse, a cause for her to return to drugs. Yet she could not simply will her addiction away, any more than she could overcome a long-term illness.
The baby was taken to the neonatal intensive care unit. When Stephanie at last met her, she was hooked up to tubes and leads, so little she thought she would harm her. Cradling her initially, she felt nothing. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
After two days she decided to give her child the name Izzie, after the nurse who had been so kind to her.
Medical personnel told her about Maddie’s Place, a new kind of care center where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still whisked to NICUs and given drugs while their mothers face custody evaluations. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when mothers and babies stay together, outcomes improve, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, a couple of employees came to collect her.
She left the medical center still in recovery, fearful and unsure about what would come next.
At Maddie’s Place, Stephanie still was concerned that child services would come remove her daughter – even though she was uncertain about motherhood. The fear lingered: that at any moment, someone could arrive and remove her child.
For the first two weeks, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Drugs 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 was unable to love herself, much less anyone else.
Every day, staff from the center took her to a treatment center, provided orally. Over time, she was beginning recovery.
She utilized each moment beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with adverse reactions to milk and obvious stomach troubles. She needed dietary support. She also had increased sensitivity and required an specialist – all common issues for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I was capable. I would become a mother.
On a day prior to the holiday, Stephanie remained in the shared space, where parents in active addiction can come for monitored interactions with their babies. An advocate, a mentor, stopped by with her own family in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in wonder of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is dressed in casual attire, a cap with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her head is tilted forward so you cannot see her face. She is lifting the baby on her knee for the other kids to see and they are crowding near, showing interest to the baby.
A young boy, eight, asked the parents: “Why are there no men?” The moms tried to explain that the men were occupied, called away to other tasks, that they would be there if they could.
“When I have kids,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and the specialist made eye contact. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I could be a mom.”
Methods to address infants affected by substances have been available for years.
The Finnegan NAS scale was created in 1975|
