She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
In her eighth month of pregnancy and suffering, a woman named Stephanie visited the ER after a serious infection started to spread up her legs. Without a job or home, cut off from her relatives, she lived in a shed she had constructed in a companion's property. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and threw up.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and use drugs.”
She had used fentanyl before arriving at the hospital and had only a brief window to get treated before she was compelled to leave to use once more. She thought she still had a month remaining to find a way to become sober and have this baby.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the leg infection was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be placed on methadone, a treatment that reduces symptoms and is often prescribed in rehabilitation.
A short time later, on 12 November 2022, Stephanie had a infant weighing just over four pounds – early, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her epidural had failed, her previous intake of fentanyl had been given four hours before delivery.
She felt sick. Unprepared to be a mother. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt awful each time she relapsed. She felt without value, berating herself for not being able to achieve the unattainable. An OBGYN told her to “only” stop using. Even her dealer would not provide 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 quit only led to increased guilt and negative self-talk, a impetus for her to return to drugs. Yet she could not simply will her addiction away, any more than she could will away a persistent condition.
The infant was moved to the special care nursery. When Stephanie eventually visited her, she was connected to medical equipment, so little she thought she would hurt her. Embracing her at last, she felt empty. “I gazed upon her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to call her daughter after her caregiver, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a unique recovery environment where parents and infants affected by substance use are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a limited but expanding group of centers like this facility is proving a simple point: when parents and infants remain united, outcomes improve, foster placements fall and future expenses reduce.
It took Stephanie a period to find strength to call, but she finally did. After ensuring she qualified for the program, care providers came to pick her up.
She left the medical center still in withdrawal, fearful and unsure about what would follow.
At Maddie’s Place, Stephanie still was concerned that child services would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any moment, someone could enter and separate them.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about getting by. Drugs came first; reliance came last.
Stephanie had a trusted ally, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She did not know how to love herself, let alone anyone else.
Every day, staff from Maddie’s Place transported her to a treatment center, given as medication. Over time, she was embracing sobriety.
She utilized each moment 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 pronounced gastrointestinal issues. She needed nutritional guidance. 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 parent.
During a pre-holiday visit, Stephanie remained in the shared space, where those still using can come for guided meetings with their babies. Katie Bunch-Smith, a mentor, came over with her own five kids in tow to deliver baked goods. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in wonder of the little newborn in Stephanie’s arms. “They had no care in the world,” 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, resting on the floor with the entryway at her back. She is slender. Her posture is humble so you do not see her expression. She is lifting the baby on her knee for the other kids to see and they are crowding near, admiring and touching to the baby.
One child, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if possible.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith made eye contact. “I became emotional,” Stephanie said. “When a child recognized that newborns require care, then I could do this. I would become a mother.”
Approaches for managing infants affected by substances have been used for a long time.
The evaluation method was established in 1975|
