She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the medical facility after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had assembled in a companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. 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 get high.”
She had used fentanyl before coming to the ER and had only a brief window to get treated before she was compelled to leave to get high again. She thought she still had several weeks to plan her recovery and deliver her child.
The nurse had other ideas. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was critical, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a drug that alleviates cravings and is commonly used in rehabilitation.
Five days later, on 12 November 2022, Stephanie had a daughter weighing just over four pounds – premature, tiny yet healthy.
When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was numb. Her pain relief did not work, her last dose of fentanyl had been administered shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Unworthy.
Stephanie had tried to get clean repeatedly before birth, and felt horrible each time she failed. She felt hopeless, blaming herself for not being able to overcome the challenge. An OBGYN told her to “simply” 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 widespread belief that her bond with her newborn would make her recover only led to increased guilt and self-abuse, a impetus for her to return to drugs. Yet she could not easily command her addiction away, any more than she could eliminate a long-term illness.
The baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to medical equipment, so little she thought she would break 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.
Two days later she decided to give her child the name Izzie, after the professional who provided support to her.
Medical personnel told her about a care center, a innovative treatment home where women and their babies are supported as a unit, not apart.
In much of the US, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still quickly moved to hospitals and given drugs while their mothers face child-protection investigations. But a small, growing network of centers like the care home is demonstrating a key fact: when mothers and babies stay together, recovery succeeds, fewer children enter care and overall savings increase.
It took Stephanie a period to find strength to call, but she eventually made the call. After ensuring she qualified for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in detox, anxious and doubtful about what would follow.
At the care center, Stephanie still worried that child services would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any moment, someone could enter and remove her child.
For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about enduring. Substances came first; reliance came last.
Stephanie had a single companion, but even that relationship was delicate. The people she loved always found ways to hurt her. She lacked the ability to love herself, not to mention anyone else.
Every day, staff from Maddie’s Place took her to a clinic for methadone, given as medication. Over time, she was beginning recovery.
She devoted all her time when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had sensory challenges and required an specialist – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I found the strength. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where parents in active addiction can come for monitored interactions with their babies. Katie Bunch-Smith, a peer support specialist, visited with her own family in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in wonder of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She keeps a photo of the moment. She is wearing dark trousers and a sweatshirt, a beanie with a pompom on her head, resting on the floor with the entryway at her back. She is lean. Her posture is humble so you do not see her expression. She is holding Izzie up on her leg for the young ones to see and they are crowding near, showing interest to the baby.
One child, eight, asked the parents: “Why are there no men?” The women attempted to clarify that the dads were busy, called away to other tasks, that they would be there given the chance.
“In the future,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
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 was able. I would become a mother.”
Tools for treating infants affected by substances have existed for decades.
The assessment tool was established in 1975|
