My Methadone Pregnancy

By Mary Elizabeth 09/16/19

I listened to what my doctor told me. I did my research and I am at peace with my decision: getting off methadone while I was pregnant just wasn’t an option.

Image: 
Pregnant woman side view, outside.
I was in a heartbreaking situation, but I needed to do what was best for the baby. ID 101017143 © Darya Petrenko | Dreamstime.com

The last time I stuck a needle in my arm was three whole months before I conceived my son, and I’m grateful that he’s never experienced me in active addiction. I say three whole months as if it were a lifetime, but it really is to anyone in early recovery. I was fortunate, I stopped using heroin before I found out that I was pregnant. I had just turned 29 and was in a stable relationship with my now-husband.

For many women, getting on methadone doesn’t happen until they find out they’re pregnant. Their options are to either keep using or get into treatment. I started taking methadone five months before I stopped using and faced a bit of a learning curve. It was difficult to separate myself from the lifestyle and the people who I interacted with on a daily basis. I also had a needle addiction, and there’s no maintenance medication for that.

When I decided to stop getting high, I immediately started trying to fix everything that I had destroyed. I was in a new relationship with someone who understood that I was broken and he took me to the methadone clinic every day. We met shortly after I got clean and he never once judged me for my past actions or made me feel bad for taking methadone during my pregnancy. Every expecting mom who takes opioids knows that if you just stop taking them, there is a high risk you will miscarry. Your baby experiences the withdrawal symptoms more strongly than you and in many cases they just aren’t strong enough to withstand it.

Making The Best Painful Choice

I was in a heartbreaking situation, but I needed to do what was best for the baby. I can see the comments already: How could you continue to take a medication like that while pregnant?! How could you do that to a tiny human, he’s going to withdraw! I heard this from my mother and a few other opinionated individuals who believed it was appropriate to weigh in on my treatment. I listened to what my doctor told me. I did my research and I am at peace with my decision: getting off methadone while I was pregnant just wasn’t an option.

The doctor at the treatment facility gave me a ton of information as to what to expect with my continuing treatment. She told me that as the baby grew, I would most likely need to take more methadone to accommodate the increased blood volume. I needed to pay attention to my symptoms and try to tell the difference between normal pregnancy discomfort and methadone withdrawal. I was really grateful for her kindness and advice, especially in the beginning. 

After I had my baby, I found out that there are many online support groups for pregnant women on maintenance medication. These sites provide information on symptoms, what is normal, the rights you have as someone who has struggled with opioid addiction, and more. It’s especially important to know what your hospital’s protocols are for infants going through opioid withdrawal. I know a lot more after giving birth than I ever did in my pregnancy.

I Would Judge Me, Too

I was afraid that Child Protective Services would be getting involved during and after my pregnancy, but I was assured by my OB-GYN and the doctor at the methadone clinic that as long as I stayed clean, I would have nothing to worry about. Still, as someone who has worked in the medical field, I knew the stigma attached to my condition. I worried at every appointment that people would look down on me and talk negatively about me after I left. I mean, I was an ex-heroin addict who was pregnant and who was continuing to put something addictive into my body. I would judge me, too.

My apprehension was unnecessary, my OB-GYN was very supportive. She referred me to a high risk maternal/fetal medicine doctor who I also saw regularly. I went to every appointment, took my methadone as prescribed, and continued to go to therapy. 

When I was about 10 weeks along, I told my parents I was pregnant. I wish I waited a little longer, but I was so excited to be a mom. Their reaction was concern that once my baby was born, he would go through withdrawal from the methadone. I tried not to take it as criticism and judgement, because their concerns were valid. I felt very guilty and scared that this little soul was going to suffer and it was all my fault.

My stepmother threw me the biggest, most elaborate baby shower that I had ever been to. She invited all of her friends and they brought me nice gifts and things I didn’t know I needed. I remember eating the cherry cake she’d ordered especially for me and starting to cry. This party was thrown for me by a woman who I’d lied to and stolen from during my addiction but none of that seemed to matter to her. She invited her friends because I only had one or two left. I’d cut contact with everyone from my previous life when I stopped using.

I chose to not go to meetings or participate in any 12-step activities because I did not want to be around other people who were struggling in the same way I was. I know that NA is a great support system and helps many people stay clean, but it wasn’t the right fit for me. Of all the resources available to me, I was the most successful with just the support of my husband, my parents, and our church.

Induction

At my 37-week appointment, the doctor found that I was low on amniotic fluid and decided I should be induced that day. I was ready, even though I was afraid of the pain and even more afraid that the painkillers wouldn’t work due to the methadone.

My husband and I hustled over to the labor and delivery wing of the hospital, excited and nervous. As expected, when I got there, I was drug tested. It was mandatory since I had a recorded history of heroin use but it still made me sad. 

The induction process was incredibly painful. I remember not wanting to ask for anything to help with the pain because I didn’t want to be judged, but as soon as I felt my cervix start to stretch, I stopped caring what anyone thought. It was brutal. After 18 hours of agony, I received an epidural. I was exhausted and excited and running on encouragement from my husband. 

Before I knew it, I was 10 centimeters dilated and surrounded by doctors who were telling me to push with each contraction. A few minutes after they set up their delivery equipment, he was here! I have never cried harder than the moment they handed me this pink, messy, angry little person. He was gooey and gross and perfect. I felt so much at once; it’s hard to explain those first few moments. He was on my chest for about 45 minutes before they cleaned him up and took him to the NICU because his blood sugar was low.

Because I had methadone in my system during my pregnancy, we had to stay for an extra five days so they could monitor my baby for withdrawal symptoms. I spent that time trying to breastfeed, learning to hold a baby properly, and getting sleep. 

My New Baby, in Opioid Withdrawal

I would like to end this by saying that we went home after the five days and lived happily ever after, but that’s not the whole story. My husband and I went home but our little boy had to stay for an extra two weeks. He started to show signs of methadone withdrawal around day five.

There are lots of myths about babies in withdrawal and what they look like. Yes, some are inconsolable and have tremors, but that isn’t always the case. I wasn’t able to recognize the symptoms in my baby because he didn’t match the picture in my head of a baby in withdrawal. 

He had a high-pitched cry; I held him against me and nursed him constantly. Sometimes it calmed him down, sometimes it wouldn’t.

In the hospital, they use a chart called the Finnegan Scale to assess the severity of withdrawal and determine if the infant needs medication, and my son’s symptoms indicated that he needed to be medicated. The doctor in the NICU told us they were going to start my baby on a small amount of morphine to calm him down and make him more comfortable. I didn’t want them to give him morphine, but I felt more strongly that I didn’t want him to suffer. 

Seeing my baby for the first time after he was medicated gave me some peace. I knew that was best for him, just like taking my methadone was best for him during my pregnancy. It’s hard to convince someone unfamiliar to the world of maintenance medications and opioid addiction that I did what was right for my baby, but I know I did.

He started getting better immediately and every day he received a little less morphine. My husband and I were lucky enough to have a private room in the NICU and be able to be with him 24-7. The most important things I did for his recovery were keeping him close to me (skin to skin contact), keeping the lights low, and the noises to a minimum. They recommended that I breastfeed as often as possible and my baby had an amazing nurse who taught me how to do this. She constantly encouraged me and kept me informed about his treatment. 

A Healthy, Happy Boy

Per hospital protocol, my husband and I were interviewed by social services. I had to be completely transparent with them and give my doctor at the methadone clinic permission to speak with them. They even came to look at my home to make sure that it was a safe place for my baby to be. I went through a variety of emotions during this time. I felt violated, angry, insulted, and even confused. I had passed every drug test for the past year and my ability to be a good mom was being questioned. The whole process lasted about a week and then we never heard from them again. I was told that the only reason that social services (CPS or DYFS depending on your state) were contacted was because there were traces of methadone in his meconium. 

Our baby boy has been growing and thriving ever since we brought him home. I still have guilt about his first few weeks in the world, but that’s okay. I try to tell myself that he wouldn’t even be here if I didn’t get on methadone in the first place, but that might just be me justifying it. I now have a smart, healthy, beautiful two-year-old little boy who never stops smiling. When he gets older, I will have to explain to him why he got sick right after he was born. I hope he understands and forgives me. 

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Mary Elizabeth is a former Emergency Medical Technician from Michigan. She is a part time student and full time mom to a little boy with another one on the way. She advocates for access to medication assisted treatment for patients in rehabilitation facilities and recovery houses. In her spare time, she writes short stories that focus on success with medication assisted treatment and personal experiences on her blog.

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