A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Saved Them Both.
Pregnant and experiencing intense discomfort, a woman named Stephanie went to the hospital emergency room after a serious infection started to spread up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had constructed in a friend’s yard. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. The onset of withdrawal began. She bent over the bedside and threw up.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and use drugs.”
She had used fentanyl before coming to the ER and had sufficient opportunity to get treated before she needed to go home to use once more. She thought she still had several weeks to find a way to become sober and deliver her child.
The medical professional intervened. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie delivered a baby girl weighing 4lb 8oz – born before term, small but alive.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “not now.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been administered shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery several times during pregnancy, and felt horrible each time she relapsed. She felt without value, berating herself for not being able to overcome the challenge. An doctor told her to “simply” stop using. Even her dealer declined to supply to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The pervasive expectation that her love for her baby would make her stop using only led to greater shame and self-harm, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a chronic disease.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was attached to monitors, so tiny she thought she would hurt her. Embracing her at last, she felt nothing. “I just stared at 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 call her daughter Izzie, after the nurse who had been so kind to her.
Medical personnel told her about a specialized facility, a new kind of care center where parents and infants affected by substance use are treated together, not apart.
In numerous states, where a baby is identified with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face custody evaluations. But a limited but expanding group of centers like the care home is demonstrating a key fact: when families are kept intact, results get better, fewer children enter care and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to bring her to the facility.
She left the medical center still in recovery, anxious and doubtful about what would follow.
At Maddie’s Place, Stephanie still worried that child services would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any point, someone could enter and separate them.
For the initial fortnight, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about survival. Addiction came first; faith came last.
Stephanie had a trusted ally, but even that relationship was delicate. The people she loved always found ways to hurt her. She did not know how to care for herself, much less anyone else.
Each day, staff from the center took her to a recovery program, provided orally. Gradually, she was beginning recovery.
She devoted all her time beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had sensory challenges and required an professional – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I could do this. I would become a mother.
On a day prior to the holiday, Stephanie was in the common room, where parents in active addiction can come for guided meetings with their babies. Katie Bunch-Smith, a mentor, came over with her own children 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 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 dressed in casual attire, a cap with a pompom on her head, seated on the ground with the exit nearby. She is lean. Her head is tilted forward so you cannot see her face. She is holding Izzie up on her lap for the children to see and they are standing close, admiring and touching to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The parents responded that the men were occupied, called away to other tasks, that they would be there given the chance.
“When I have kids,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith made eye contact. “I became emotional,” Stephanie said. “If this little kid could see that newborns require care, then I was able. I would become a mother.”
Tools for treating babies with exposure have existed for decades.
The assessment tool was established in 1975|
