Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.

Pregnant and experiencing intense discomfort, a woman named Stephanie went to the ER after an infection began spreading up her legs. Without a job or home, separated from loved ones, she lived in a shed she had assembled in a companion's property. She was also dependent on fentanyl.

As doctors treated her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and threw up.

Stephanie eventually collapsed. “I have to get out of here. I have to go home and use drugs.”

She had consumed opioids before coming to the ER and had just enough time to get treated before she needed to go home to relapse. She thought she still had several weeks to plan her recovery and deliver her child.

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

“Yes, I am,” Stephanie said.

But the doctors would not let her go: the leg infection was serious, but physicians found she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, she and her baby would not survive.

The nurse convinced 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 drug that alleviates cravings and is frequently utilized in substance abuse treatment.

Five days later, on 12 November 2022, Stephanie had a daughter weighing a small weight – premature, little but surviving.

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 final administration of fentanyl had been administered shortly before she gave birth.

She felt unwell. Unprepared to be a mother. Unworthy.

Stephanie had tried to get clean multiple times while expecting, and felt awful each time she relapsed. She felt hopeless, criticizing herself for not being able to achieve the unattainable. An OBGYN told her to “simply” stop using. Even her supplier would not provide to her when she became obviously with child.

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

The common assumption that her bond with her newborn would make her recover only led to greater shame and self-abuse, a trigger 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 infant was moved to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to monitors, so tiny she thought she would harm her. Holding her for the first time, she felt empty. “I just stared at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.

After two days she decided to call her daughter Izzie, after the nurse who had been so kind to her.

Hospital staff told her about a care center, a new kind of care center where women and their babies are treated together, not apart.

In numerous states, where a baby is identified with newborn addiction symptoms regularly, infants are still rushed to special care and given drugs while their mothers face parental assessments. But a developing system of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, recovery succeeds, foster placements fall and overall savings increase.

It took Stephanie a period to find strength to call, but she finally did. After confirming she would be a good fit for the program, two staff members came to pick her up.

She stepped out of the hospital still in recovery, fearful and unsure about what would follow.

At the facility, Stephanie still feared that child services would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could arrive and take her baby away.

For the first two weeks, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”

Life on the streets, she said, was about getting by. Substances came first; trust came last.

Stephanie had a single companion, but even that relationship was delicate. The people she loved always found ways to cause pain. She did not know how to love herself, much less anyone else.

Daily, staff from the facility drove her to a treatment center, administered in pill form. Slowly, she was embracing sobriety.

She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed nutritional guidance. She also had heightened sensory issues and required an professional – all typical problems for babies exposed to substances.

Seeing that even a young person understands the need for care, then I found the strength. I could parent.

One afternoon before Thanksgiving, Stephanie sat in the visitation area, where those still using can come for guided meetings with their babies. A support specialist, a peer support specialist, stopped by with her own family in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.

The young ones stared in wonder 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 keeps a photo of the moment. She is wearing casual attire, a gray knit hat with a decoration on her head, seated on the ground with the door behind her. She is slender. Her posture is humble so you cannot see her face. She is presenting her daughter on her leg for the young ones to see and they are gathered around, admiring and touching to the baby.

Jacob, eight, asked the moms: “Where are all the dads?” The women attempted to clarify that the dads were busy, engaged elsewhere, that they would be there if they could.

“When I have kids,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”

Stephanie and Bunch-Smith looked at each other. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I would become a mother.”

Methods to address babies with exposure have been available for years.

The Finnegan NAS scale was established in 1975|