Fentanyl Addiction During Pregnancy: Choosing Motherhood Saved Them Both.

Pregnant and experiencing intense discomfort, the expectant mother arrived at the hospital emergency room after an infection began spreading up her legs. Jobless and without shelter, separated from loved ones, she stayed in a makeshift shelter she had constructed in a friend’s yard. She was also hooked on fentanyl.

As physicians addressed her infection, she began to panic. Symptoms of withdrawal emerged. She leaned over the bed and became sick.

Stephanie finally broke down. “I have to get out of here. I have to go home and take a hit.”

She had used fentanyl before coming to the ER and had only a brief window to get treated before she had to return to get high again. She thought she still had several weeks to plan her recovery and have this baby.

The nurse had other ideas. She told Stephanie she was staying put.

“I am leaving,” Stephanie said.

But the doctors would not let her go: the infection in her legs was critical, but medical staff detected she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would not survive.

Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be placed on methadone, a medication that eases withdrawal and is commonly used in rehabilitation.

After five days, on the 12th of November, Stephanie had a infant weighing a small weight – early, little but surviving.

When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been provided shortly before she gave birth.

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

Stephanie had sought recovery repeatedly before birth, and felt horrible each time she failed. She felt worthless, blaming herself for not being able to overcome the challenge. An OBGYN 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 love for her baby would make her quit only led to greater shame and negative self-talk, a impetus for her to return to drugs. Yet she could not just wish her addiction away, any more than she could will away a long-term illness.

The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was hooked up to tubes and leads, so tiny she thought she would break her. Embracing her at last, she felt nothing. “I gazed upon her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.

Following a brief period she decided to name her baby after her caregiver, after the professional who provided support to her.

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

In numerous states, where a baby is identified with infant withdrawal condition frequently, infants are still rushed to special care and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like the care home is proving a simple point: when parents and infants remain united, results get better, 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, two staff members came to collect her.

She stepped out of the hospital still in withdrawal, scared and uncertain about what would follow.

At Maddie’s Place, Stephanie still was concerned that child services would come take Izzie – even though she was hesitant about parenting. The concern persisted: that at any moment, someone could arrive and separate them.

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

Life on the streets, she said, was about enduring. Drugs came first; reliance came last.

Stephanie had one close friend, but even that relationship was delicate. The people she loved always found ways to hurt her. She was unable to value herself, not to mention anyone else.

Each day, staff from Maddie’s Place drove her to a treatment center, given as medication. Gradually, she was embracing sobriety.

She spent every minute when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with intolerance to some formulas and severe digestive problems. She needed feeding therapy. She also had sensory challenges and required an occupational therapist – all typical problems for babies born with NAS.

When a child recognizes these infants need affection, then I could do this. I could be a mom.

During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for monitored interactions with their babies. An advocate, a recovery coach, stopped by with her own family 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 small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”

She has an image of the moment. She is dressed in dark trousers and a sweatshirt, a cap with a decoration on her head, resting on the floor with the exit nearby. She is thin. Her face is downcast so you do not see her expression. She is lifting the baby on her knee for the other kids to see and they are crowding near, admiring and touching to the baby.

One child, eight, asked the parents: “Where are all the dads?” The parents responded that the fathers had obligations, called away to other tasks, that they would be there if possible.

“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 her companion exchanged glances. “I broke down,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I found the courage. I could be a mom.”

Methods to address drug-exposed newborns have been available for years.

The assessment tool was established in 1975|