A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Transformed Their Futures.
Eight months pregnant and in severe pain, a woman named Stephanie arrived at the ER after her infection worsened up her legs. Unemployed and homeless, cut off from her relatives, she resided in a small structure she had assembled in a friend’s yard. 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 became sick.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before coming to the ER and had sufficient opportunity to get treated before she needed to go home to relapse. She thought she still had several weeks to plan her recovery and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but doctors had discovered she also had an ruptured membrane. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is often prescribed in rehabilitation.
A short time later, on a day in November 2022, Stephanie delivered a baby girl weighing just over four pounds – born before term, tiny yet healthy.
When the attendant inquired if she wanted to embrace her child, Stephanie said “I cannot.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean repeatedly before birth, 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 “just” stop using. Even her supplier would not provide to her when she became obviously with child.
“However, I failed,” she said. “I had to seek support.”
The widespread belief that her love for her baby would make her stop using only led to deeper self-loathing and self-abuse, a trigger for her to return to drugs. Yet she could not just wish her addiction away, any more than she could eliminate a chronic disease.
The infant was moved to the neonatal intensive care unit. When Stephanie finally saw her her, she was hooked up to medical equipment, so small she thought she would break her. Embracing her at last, she felt detached. “I just stared at her and was like, ‘What am I going to do with 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 attendant who showed compassion to her.
Hospital staff told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is identified with infant withdrawal condition frequently, infants are still rushed to special care and treated with pharmaceuticals while their mothers face custody evaluations. But a small, growing network of centers like this facility is proving a simple point: when families are kept intact, outcomes improve, custody cases decrease and future expenses reduce.
It took Stephanie a period to find strength to call, but she eventually made the call. After confirming she would be a good fit for the program, two staff members came to bring her to the facility.
She departed the institution still in detox, fearful and unsure about what would happen next.
At the care center, Stephanie still feared that child services would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any point, someone could enter and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Addiction came first; reliance came last.
Stephanie had a trusted ally, but even that bond was fragile. The individuals she cared for always found ways to cause pain. She lacked the ability to love herself, let alone anyone else.
Each day, staff from the facility took her to a clinic for methadone, administered in pill form. Over time, she was starting to get clean.
She spent every minute when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and severe digestive problems. She needed feeding therapy. She also had increased sensitivity and required an specialist – all typical problems for babies affected by withdrawal.
When a child recognizes these infants need affection, then I could do this. I could parent.
On a day prior to the holiday, Stephanie remained in the shared space, where individuals struggling with substance use can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, stopped by with her own five kids in tow to bring treats. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She has an image of the moment. She is wearing black pants and a hoodie, a gray knit hat with a pompom on her head, resting on the floor with the exit nearby. She is thin. Her posture is humble so you miss her features. She is holding Izzie up on her lap for the young ones to see and they are crowding near, showing interest to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The women attempted to clarify that the dads were busy, handling responsibilities, that they would be there if they could.
“When I have kids,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and Bunch-Smith looked at each other. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I could be a mom.”
Approaches for managing babies with exposure have been used for a long time.
The evaluation method was established in 1975|
