She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Transformed Their Futures.
In her eighth month of pregnancy and suffering, the expectant mother went to the medical facility after a serious infection started to spread up her legs. Jobless and without shelter, separated from loved ones, she resided in a small structure she had constructed in a acquaintance's garden. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and threw up.
Stephanie eventually collapsed. “I need to leave. 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 had to return to relapse. She thought she still had several weeks to find a way to become sober and deliver her child.
The attending nurse disagreed. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was serious, but doctors had discovered she also had an ruptured membrane. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is commonly used in substance abuse treatment.
Five days later, on the 12th of November, Stephanie had a infant weighing just over four pounds – born before term, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her epidural had failed, her last dose of fentanyl had been administered shortly before she gave birth.
She felt ill. Unprepared to be a mother. Undeserving.
Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she relapsed. She felt worthless, berating herself for not being able to do the impossible. An obstetrician told her to “just” stop using. Even her source declined to supply to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The pervasive expectation that her affection for her child would make her recover only led to increased guilt and negative self-talk, a cause for her to return to drugs. Yet she could not just wish her addiction away, any more than she could eliminate a persistent condition.
The baby was taken to the NICU. When Stephanie at last met her, she was attached to monitors, so little she thought she would harm her. Holding her for the first time, she felt empty. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure 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 innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is found to have newborn addiction symptoms regularly, infants are still whisked to NICUs and given drugs while their mothers face child-protection investigations. But a developing system of centers like this facility is showing an important truth: when families are kept intact, results get better, custody cases decrease and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, a couple of employees came to collect her.
She stepped out of the hospital still in detox, anxious and doubtful about what would come next.
At the facility, Stephanie still feared that CPS would come remove her daughter – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could enter and take her baby away.
For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about survival. Substances came first; trust came last.
Stephanie had a trusted ally, but even that bond was fragile. The those close to her always found ways to let her down. She lacked the ability to value herself, much less anyone else.
Every day, staff from the facility transported her to a recovery program, provided orally. Gradually, she was starting to get clean.
She spent every minute 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 intolerance to some formulas and pronounced gastrointestinal issues. She needed nutritional guidance. She also had increased sensitivity and required an specialist – 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 was in the common room, where parents in active addiction can come for supervised visits with their babies. A support specialist, a recovery coach, stopped by with her own five kids in tow to deliver baked goods. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in admiration of the little newborn 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 has an image of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, seated on the ground 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 crowding near, fawning and reaching out to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The women attempted to clarify that the men were occupied, called away to other tasks, that they would be there if they could.
“In the future,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and the specialist made eye contact. “I broke down,” Stephanie said. “When a child recognized that infants need affection, then I found the courage. I would become a mother.”
Approaches for managing babies with exposure have been used for a long time.
The Finnegan NAS scale was established in 1975|
