A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother visited the hospital emergency room after an infection began spreading up her legs. Jobless and without shelter, 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 began to panic. The onset of withdrawal began. She bent over the bedside and threw up.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before seeking medical help and had just enough time to get treated before she had to return to relapse. She thought she still had a month remaining to figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was critical, but medical staff detected she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is frequently utilized in rehabilitation.
After five days, on a day in November 2022, Stephanie delivered a baby girl weighing 4lb 8oz – born before term, small but alive.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was emotionless. Her pain relief did not work, her last dose of fentanyl had been provided shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she relapsed. She felt without value, blaming herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her source declined to supply to her when she became visibly pregnant.
“But I couldn’t,” she said. “I required assistance.”
The pervasive expectation that her bond with her newborn would make her stop using only led to greater shame and self-harm, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The newborn was transferred to the neonatal intensive care unit. When Stephanie eventually visited her, she was hooked up to medical equipment, so little she thought she would break her. Cradling her initially, she felt detached. “I just stared at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to name her baby the same as her nurse, after the professional who provided support to her.
Hospital staff told her about a specialized facility, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In many parts of America, where a baby is identified with newborn addiction symptoms frequently, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a limited but expanding group of centers like the care home is demonstrating a key fact: when families are kept intact, recovery succeeds, fewer children enter care and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, two staff members came to bring her to the facility.
She left the medical center still in recovery, anxious and doubtful about what would come next.
At the facility, Stephanie still worried that child services would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could walk in and separate them.
For the initial fortnight, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about enduring. Drugs came first; trust came last.
Stephanie had a single companion, but even that connection was tenuous. The people she loved always found ways to cause pain. She was unable to care for herself, let alone anyone else.
Daily, staff from the facility transported her to a recovery program, administered in pill form. Over time, she was starting to get clean.
She utilized each moment when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed dietary support. She also had increased sensitivity and required an occupational therapist – all common issues for babies exposed to substances.
When a child recognizes these infants need affection, then I could do this. I could parent.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where parents in active addiction can come for supervised visits with their babies. A support specialist, a peer support specialist, stopped by with her own children in tow to deliver baked goods. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a pompom on her head, resting on the floor with the exit nearby. She is thin. Her face is downcast so you miss her features. She is lifting the baby on her lap for the other kids to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the parents: “Why are there no men?” The women attempted to clarify that the fathers had obligations, handling responsibilities, that they would be there given the chance.
“When I have kids,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and her companion exchanged glances. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that newborns require care, then I was able. I could be a mom.”
Approaches for managing babies with exposure have been available for years.
The evaluation method was created in 1975|
