She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
Pregnant and experiencing intense discomfort, a woman named Stephanie visited the medical facility after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had assembled in a friend’s yard. She was also hooked on fentanyl.
As medical staff managed her infection, she started to feel anxious. The onset of withdrawal began. She bent over the bedside and vomited.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and get high.”
She had taken the drug before coming to the ER and had only a brief window to get treated before she had to return to get high again. She thought she still had several weeks to plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was severe, but physicians found she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she departed, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in rehabilitation.
A short time later, on 12 November 2022, Stephanie gave birth to a daughter weighing just over four pounds – born before term, little but surviving.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been provided a few hours prior to birth.
She felt sick. Not ready for motherhood. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt awful each time she relapsed. She felt worthless, criticizing herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her dealer declined to supply to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her recover only led to increased guilt and negative self-talk, a cause for her to relapse. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The baby was taken to the neonatal intensive care unit. When Stephanie at last met her, she was attached to tubes and leads, so small she thought she would harm her. Holding her for the first time, she felt empty. “I looked at her and was like, ‘What am I going to do with 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 nurse who had been so kind to her.
Hospital staff told her about a care center, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face child-protection investigations. But a developing system of centers like the care home is proving a simple point: when parents and infants remain united, recovery succeeds, fewer children enter care and future expenses reduce.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, a couple of employees came to pick her up.
She departed the institution still in detox, fearful and unsure about what would follow.
At the care center, Stephanie still was concerned that child services would come seize her child – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could enter and separate them.
For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about survival. Addiction came first; trust came last.
Stephanie had a single companion, but even that relationship was delicate. The individuals she cared for always found ways to cause pain. She lacked the ability to care for herself, not to mention anyone else.
Daily, staff from the facility drove her to a recovery program, provided orally. Gradually, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and severe digestive problems. She needed dietary support. She also had sensory challenges and required an occupational therapist – all frequent conditions for babies exposed to substances.
Seeing that even a young person understands the need for care, then I was capable. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for guided meetings with their babies. Katie Bunch-Smith, a mentor, came over with her own children in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in awe of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is clad in black pants and a hoodie, a cap with a bobble on her head, sitting on the wooden floor with the door behind her. She is thin. Her face is downcast so you do not see her expression. She is lifting the baby on her lap for the children to see and they are standing close, admiring and touching to the baby.
A young boy, eight, asked the mothers: “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 plan to be a great parent. I will teach them about love.”
Stephanie and Bunch-Smith exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I could do this. I could parent.”
Methods to address drug-exposed newborns have been used for a long time.
The assessment tool was created in 1975|
