She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
In her eighth month of pregnancy and suffering, the expectant mother visited the hospital emergency room after an infection began spreading up her legs. Without a job or home, estranged from her family, she lived in a shed she had built in a companion's property. She was also addicted to fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Withdrawal was setting in. She bent over the bedside and vomited.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and take a hit.”
She had taken the drug before coming to the ER and had just enough time to get treated before she needed to go home to get high again. She thought she still had a month remaining to figure out how to get clean and have this baby.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be transitioned to methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.
A short time later, on the 12th of November, Stephanie gave birth to a baby girl weighing a small weight – early, little but surviving.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been provided four hours before delivery.
She felt unwell. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she relapsed. She felt hopeless, 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 visibly pregnant.
“However, I failed,” she said. “I needed help.”
The common assumption that her love for her baby would make her stop using only led to increased guilt and self-harm, a trigger for her to return to drugs. Yet she could not easily command her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the NICU. When Stephanie eventually visited her, she was attached to tubes and leads, so small she thought she would hurt her. Cradling her initially, she felt detached. “I gazed upon her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the professional who provided support to her.
Hospital staff told her about a specialized facility, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In many parts of America, where a baby is diagnosed with neonatal abstinence syndrome (NAS) regularly, infants are still quickly moved to hospitals and medicated while their mothers face parental assessments. But a limited but expanding group of centers like this facility is showing an important truth: when families are kept intact, recovery succeeds, foster placements fall and long-term costs decline.
It took Stephanie some time to build confidence to call, but she finally did. After confirming she would be a good fit for the program, two staff members came to collect her.
She departed the institution still in detox, scared and uncertain about what would happen next.
At the care center, Stephanie still feared that child services would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any point, someone could arrive and take her baby away.
For the initial fortnight, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about survival. Drugs came first; trust came last.
Stephanie had a trusted ally, but even that relationship was delicate. The individuals she cared for always found ways to hurt her. She was unable to love herself, much less anyone else.
Daily, staff from the facility transported her to a treatment center, given as medication. Slowly, she was embracing sobriety.
She devoted all her time outside treatment with Izzie, and could see that her baby was getting the specialized care 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 professional – all common issues for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
On a day prior to the holiday, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a peer support specialist, stopped by with her own children in tow to deliver baked goods. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She has an image of the moment. She is clad in black pants and a hoodie, a gray knit hat with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is lean. Her posture is humble so you miss her features. She is presenting her daughter on her lap for the children to see and they are crowding near, fawning and reaching out to the baby.
One child, eight, asked the moms: “Where are all the dads?” The parents responded that the men were occupied, engaged elsewhere, that they would be there if possible.
“In the future,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion made eye contact. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I could do this. I would become a mother.”
Methods to address babies with exposure have been available for years.
The evaluation method was established in 1975|
