Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.

Eight months pregnant and in severe pain, the expectant mother went to the hospital emergency room after an infection began spreading up her legs. Unemployed and homeless, separated from loved ones, she stayed in a makeshift shelter she had built in a friend’s yard. She was also addicted to fentanyl.

As doctors treated her infection, she began to panic. The onset of withdrawal began. She leaned over the bed and became sick.

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

She had consumed opioids before arriving at the hospital and had only a brief window to get treated before she needed to go home to relapse. She thought she still had four weeks left to find a way to become sober and give birth.

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 condition in her limbs was severe, but physicians found she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would be at risk of death.

She encouraged the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a treatment that reduces symptoms and is often prescribed in rehabilitation.

Five days later, on 12 November 2022, Stephanie had a infant weighing a small weight – early, small but alive.

When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her pain relief did not work, her final administration of fentanyl had been administered a few hours prior to birth.

She felt unwell. Ill-equipped for parenting. Undeserving.

Stephanie had sought recovery repeatedly before birth, and felt terrible each time she was unsuccessful. She felt without value, blaming herself for not being able to overcome the challenge. An obstetrician told her to “only” stop using. Even her supplier would not provide to her when she became obviously with child.

“Yet I was unable,” she said. “I had to seek support.”

The pervasive expectation that her love for her baby would make her quit only led to deeper self-loathing and negative self-talk, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a persistent condition.

The infant was moved to the special care nursery. When Stephanie at last met her, she was connected 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, ‘What is our future?’” She remained uncertain she wanted to be her mother.

Two days later she decided to give her child the name after her caregiver, after the professional who provided support to her.

Medical personnel told her about a care center, a unique recovery environment where women and their babies are cared for jointly, not apart.

In many parts of America, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face child-protection investigations. But a developing system of centers like the care home is demonstrating a key fact: when mothers and babies stay together, recovery succeeds, foster placements fall and long-term costs decline.

It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to collect her.

She left the medical center still in recovery, fearful and unsure about what would come next.

At the facility, Stephanie still was concerned that CPS would come take Izzie – even though she was not sure she wanted to keep her. The concern persisted: that at any moment, someone could enter and take her baby away.

For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”

Homelessness, she said, was about getting by. Drugs came first; reliance came last.

Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to cause pain. She lacked the ability to value herself, let alone anyone else.

Every day, staff from the facility transported her to a clinic for methadone, administered in pill form. Slowly, she was embracing sobriety.

She utilized each moment beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and obvious stomach troubles. She needed nutritional guidance. She also had heightened sensory issues and required an professional – all common issues for babies exposed to substances.

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

One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a recovery coach, visited with her own five kids in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.

The children were wide-eyed in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”

She has an image of the moment. She is dressed in dark trousers and a sweatshirt, a gray knit hat 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 leg for the children to see and they are gathered around, showing interest to the baby.

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

“In the future,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”

Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I could do this. I would become a mother.”

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

The Finnegan NAS scale was created in 1975|