Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Saved Them Both.

Pregnant and experiencing intense discomfort, the expectant mother went to the medical facility after an infection began spreading up her legs. Jobless and without shelter, separated from loved ones, she lived in a shed she had constructed in a companion's property. She was also dependent on fentanyl.

As medical staff managed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and threw up.

Stephanie eventually collapsed. “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 plan her recovery and give birth.

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

“I am leaving,” Stephanie said.

But the hospital refused to discharge her: the infection in her legs was serious, but physicians found she also had an ruptured membrane. The nurse, her nurse, warned her: if she left, she and her baby would face grave danger.

Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be switched to methadone, a medication that eases withdrawal and is frequently utilized in addiction recovery.

Five days later, on the 12th of November, Stephanie delivered a infant weighing just over four pounds – early, small but alive.

When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been given four hours before delivery.

She felt ill. Ill-equipped for parenting. Unworthy.

Stephanie had sought recovery several times during pregnancy, and felt awful each time she relapsed. She felt hopeless, berating herself for not being able to achieve the unattainable. An doctor told her to “just” stop using. Even her source declined to supply to her when she became obviously with child.

“Yet I was unable,” she said. “I required assistance.”

The pervasive expectation that her love for her baby would make her stop using only led to increased guilt and negative self-talk, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could eliminate a long-term illness.

The baby was taken to the NICU. When Stephanie eventually visited her, she was attached to monitors, so small she thought she would harm her. Holding her for the first time, she felt empty. “I gazed upon her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.

Two days later she decided to call her daughter after her caregiver, after the professional who provided support to her.

Medical personnel told her about a care center, a new kind of care center where mothers and their drug-exposed newborns are cared for jointly, not apart.

In much of the US, 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 limited but expanding group of centers like the care home is demonstrating a key fact: when parents and infants remain united, outcomes improve, custody cases decrease and long-term costs decline.

It took Stephanie a period to find strength to call, but she finally did. After verifying her eligibility for the program, a couple of employees came to collect her.

She left the medical center still in detox, scared and uncertain about what would come next.

At Maddie’s Place, Stephanie still feared that child services would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could walk in and remove her child.

For the beginning period, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”

Survival outdoors, she said, was about survival. Substances came first; faith came last.

Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to cause pain. She lacked the ability to care for herself, let alone anyone else.

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

She devoted all her time when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with adverse reactions to milk and obvious stomach troubles. She needed feeding therapy. She also had heightened sensory issues and required an specialist – all typical problems for babies affected by withdrawal.

If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.

During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for monitored interactions with their babies. An advocate, a peer support specialist, came over with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was sitting on the floor 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. “My past did not matter to them. Such issues were irrelevant.”

She holds a picture of the moment. She is clad in casual attire, a beanie with a pompom on her head, seated on the ground with the exit nearby. She is thin. Her posture is humble so you cannot see her face. She is lifting the baby on her leg for the children to see and they are standing close, admiring and touching to the baby.

One child, eight, asked the moms: “Where are all the dads?” The parents responded that the dads were busy, called away to other tasks, that they would be there if they could.

“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”

Stephanie and the specialist looked at each other. “I broke down,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I was able. I could parent.”

Tools for treating drug-exposed newborns have existed for decades.

The assessment tool was developed in 1975|