She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother went to the medical facility after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she stayed in a makeshift shelter she had built in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Withdrawal was setting in. She slumped forward and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and get high.”
She had taken the drug before seeking medical help and had only a brief window 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 attending nurse disagreed. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the leg infection was critical, but doctors had discovered she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is often prescribed in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie gave birth to a baby girl weighing a small weight – early, little but surviving.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was numb. Her pain relief did not work, her last dose of fentanyl had been provided shortly before she gave birth.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had tried to get clean multiple times while expecting, and felt awful each time she failed. She felt hopeless, criticizing herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her supplier refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The common assumption that her bond with her newborn would make her quit only led to greater shame and negative self-talk, a cause for her to use again. Yet she could not simply will her addiction away, any more than she could will away a persistent condition.
The infant was moved to the NICU. When Stephanie finally saw her her, she was connected to monitors, so tiny she thought she would hurt her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
After two days she decided to give her child the name after her caregiver, after the professional who provided support to her.
Nurses and doctors told her about a care center, a innovative treatment home where mothers and their drug-exposed newborns are treated together, not apart.
In much of the US, where a baby is identified with newborn addiction symptoms frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a developing system of centers like the care home is showing an important truth: when families are kept intact, outcomes improve, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, a couple of employees came to bring her to the facility.
She departed the institution still in recovery, anxious and doubtful about what would follow.
At the care center, Stephanie still was concerned that authorities would come seize her child – even though she was not sure she wanted to keep her. The concern persisted: that at any moment, someone could walk in and remove her child.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about getting by. Addiction came first; trust came last.
Stephanie had one close friend, but even that relationship was delicate. The people she loved always found ways to let her down. She lacked the ability to care for herself, not to mention anyone else.
Each day, staff from Maddie’s Place drove her to a clinic for methadone, provided orally. Gradually, she was starting to get clean.
She devoted all her time outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges 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 typical problems for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I found the strength. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where those still using can come for supervised visits with their babies. Katie Bunch-Smith, a mentor, came over with her own children in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in wonder of the tiny infant in Stephanie’s arms. “They were innocent,” 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 beanie with a bobble on her head, resting on the floor with the entryway at her back. She is thin. Her posture is humble so you cannot see her face. She is lifting the baby on her lap for the young ones to see and they are standing close, showing interest to the baby.
A young boy, eight, asked the moms: “Why are there no men?” The moms tried to explain that the men were occupied, engaged elsewhere, that they would be there given the chance.
“In the future,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I would become a mother.”
Approaches for managing drug-exposed newborns have existed for decades.
The Finnegan NAS scale was created in 1975|
