A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
Pregnant and experiencing intense discomfort, the expectant mother went to the medical facility after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had assembled in a acquaintance's garden. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. The onset of withdrawal began. She bent over the bedside and threw up.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”
She had taken the drug before seeking medical help and had only a brief window to get treated before she needed to go home to get high again. She thought she still had a month remaining to find a way to become sober and have this baby.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the infection in her legs was critical, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
She encouraged the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a drug that alleviates cravings and is commonly used in substance abuse treatment.
After five days, on the 12th of November, Stephanie delivered a baby girl weighing just over four pounds – early, little but surviving.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been provided a few hours prior to birth.
She felt ill. Not ready for motherhood. Unworthy.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she was unsuccessful. She felt hopeless, criticizing herself for not being able to overcome the challenge. An doctor told her to “only” 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 affection for her child would make her stop using only led to greater shame and self-abuse, a impetus 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 neonatal intensive care unit. When Stephanie eventually visited her, she was hooked up to tubes and leads, so small she thought she would harm her. Cradling her initially, she felt empty. “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 after her caregiver, after the professional who provided support to her.
Nurses and doctors told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition regularly, infants are still whisked to NICUs and given drugs while their mothers face custody evaluations. But a developing system of centers like the care home is proving a simple point: when families are kept intact, results get better, fewer children enter care and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After confirming she would be a good fit for the program, a couple of employees came to pick her up.
She left the medical center still in detox, scared and uncertain about what would come next.
At the care center, Stephanie still feared that CPS would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any moment, someone could enter and remove her child.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Addiction came first; trust came last.
Stephanie had a single companion, but even that relationship was delicate. The people she loved always found ways to let her down. She lacked the ability to care for herself, not to mention anyone else.
Each day, staff from the center transported her to a recovery program, given as medication. Slowly, she was starting to get clean.
She spent every minute when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed dietary support. 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 was capable. I would become a mother.
On a day prior to the holiday, Stephanie remained in the shared space, where those still using can come for monitored interactions with their babies. A support specialist, a recovery coach, visited with her own five kids in tow to drop off cookies. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in admiration of the tiny infant 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 beanie with a decoration on her head, resting on the floor with the exit nearby. She is thin. Her face is downcast so you miss her features. She is presenting her daughter on her knee for the children to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the parents: “What about the fathers?” The women attempted to clarify that the dads were busy, called away to other tasks, that they would be there given the chance.
“When I have kids,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and Bunch-Smith exchanged glances. “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.”
Tools for treating babies with exposure have been used for a long time.
The evaluation method was developed in 1975|
