She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
Pregnant and experiencing intense discomfort, a woman named Stephanie arrived at the medical facility after her infection worsened up her legs. Without a job or home, separated from loved ones, she lived in a shed she had assembled in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she started to feel anxious. The onset of withdrawal began. She bent over the bedside and threw up.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had taken the drug before arriving at the hospital and had just enough time to get treated before she had to return to use once more. She thought she still had a month remaining to plan her recovery and have this baby.
The medical professional intervened. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
She encouraged the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be placed on methadone, a medication that eases withdrawal and is often prescribed in substance abuse treatment.
Five days later, on a day in November 2022, Stephanie delivered a infant weighing just over four pounds – born before term, small but alive.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “I cannot.” She was emotionless. Her epidural had failed, her final administration of fentanyl had been given a few hours prior to birth.
She felt unwell. Unprepared to be a mother. Undeserving.
Stephanie had sought recovery multiple times while expecting, and felt horrible each time she failed. She felt without value, blaming herself for not being able to overcome the challenge. An doctor told her to “only” stop using. Even her supplier would not provide to her when she became obviously with child.
“Yet I was unable,” she said. “I required assistance.”
The common assumption that her affection for her child would make her recover only led to greater shame and self-abuse, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was hooked up to monitors, so tiny she thought she would break her. Holding her for the first time, she felt nothing. “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.
After two days she decided to give her child the name after her caregiver, after the nurse who had been so kind to her.
Medical personnel told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are treated together, not apart.
In much of the US, where a baby is identified with neonatal abstinence syndrome (NAS) frequently, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a developing system of centers like the care home is demonstrating a key fact: when mothers and babies stay together, results get better, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After ensuring she qualified for the program, a couple of employees came to collect her.
She left the medical center still in recovery, fearful and unsure about what would come next.
At the facility, Stephanie still worried that authorities would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any point, someone could enter and remove her child.
For the first two weeks, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Substances came first; trust came last.
Stephanie had a single companion, but even that connection was tenuous. The people she loved always found ways to hurt her. She lacked the ability to care for herself, let alone anyone else.
Every day, staff from the facility drove her to a recovery program, administered in pill form. Slowly, she was starting to get clean.
She devoted all her time beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and obvious stomach troubles. She needed feeding therapy. She also had heightened sensory issues and required an specialist – all common issues for babies affected by withdrawal.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
On a day prior to the holiday, Stephanie was in the common room, where parents in active addiction can come for monitored interactions with their babies. An advocate, a peer support specialist, came over with her own children in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in awe 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 holds a picture of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a pompom on her head, seated on the ground with the entryway at her back. She is thin. Her head is tilted forward so you miss her features. She is holding Izzie up on her knee for the young ones to see and they are crowding near, admiring and touching to the baby.
Jacob, eight, asked the parents: “Where are all the dads?” The parents responded that the dads were busy, engaged elsewhere, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and Bunch-Smith made eye contact. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I could do this. I would become a mother.”
Methods to address infants affected by substances have been available for years.
The evaluation method was created in 1975|
