Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Rescued Both Lives.

Pregnant and experiencing intense discomfort, the expectant mother went to the medical facility after an infection began spreading up her legs. Unemployed and homeless, separated from loved ones, she resided in a small structure she had built in a acquaintance's garden. She was also addicted to fentanyl.

As doctors treated her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and became sick.

Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and get high.”

She had consumed opioids before arriving at the hospital and had only a brief window to get treated before she had to return to relapse. She thought she still had several weeks to plan her recovery and give birth.

The medical professional intervened. She told Stephanie she was staying put.

“I am leaving,” Stephanie said.

But the doctors would not let her go: the leg infection was critical, but physicians found she also had an amniotic fluid leak. The nurse, her nurse, 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 abstinence might harm her and the baby. Post-birth Stephanie would be transitioned to methadone, a drug that alleviates cravings and is often prescribed in rehabilitation.

After five days, on the 12th of November, Stephanie had a infant weighing 4lb 8oz – born before term, tiny yet healthy.

When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her epidural had failed, her last dose of fentanyl had been administered four hours before delivery.

She felt ill. Not ready for motherhood. Undeserving.

Stephanie had tried to get clean multiple times while expecting, and felt awful each time she relapsed. She felt hopeless, blaming herself for not being able to overcome the challenge. An doctor told her to “simply” stop using. Even her source refused to sell to her when she became obviously with child.

“But I couldn’t,” she said. “I required assistance.”

The widespread belief that her affection for her child would make her stop using only led to greater shame and self-harm, a impetus for her to relapse. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.

The baby was taken to the NICU. When Stephanie eventually visited her, she was connected to medical equipment, so small she thought she would break her. Holding her for the first time, she felt empty. “I just stared 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 the same as her nurse, after the attendant who showed compassion to her.

Hospital staff told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.

In many parts of America, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a small, growing network of centers like this facility is demonstrating a key fact: when families are kept intact, results get better, custody cases decrease and future expenses reduce.

It took Stephanie a while to gather the courage to call, but she finally did. After verifying her eligibility for the program, care providers came to bring her to the facility.

She departed the institution still in detox, fearful and unsure about what would follow.

At the care center, Stephanie still feared that child services would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could walk in and remove her child.

For the beginning period, Stephanie stayed withdrawn. “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 a single companion, but even that connection was tenuous. The people she loved always found ways to hurt her. She was unable to love herself, let alone anyone else.

Every day, staff from Maddie’s Place took her to a recovery program, administered in pill form. Slowly, she was embracing sobriety.

She devoted all her time outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed dietary support. She also had sensory challenges and required an professional – all frequent conditions for babies exposed to substances.

Seeing that even a young person understands the need for care, then I could do this. I could be a mom.

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 mentor, came over with her own children 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 had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”

She keeps a photo of the moment. She is wearing dark trousers and a sweatshirt, a cap 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 do not see her expression. She is holding Izzie up on her leg for the young ones to see and they are crowding near, admiring and touching to the baby.

Jacob, eight, asked the mothers: “Where are all the dads?” The parents responded that the men were occupied, engaged elsewhere, that they would be there given the chance.

“Once I become a parent,” Jacob said, “I will excel as a father. I will teach them about love.”

Stephanie and her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that newborns require care, then I could do this. I could parent.”

Approaches for managing babies with exposure have been used for a long time.

The Finnegan NAS scale was created in 1975|