A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Saved Them Both.
Eight months pregnant and in severe pain, a woman named Stephanie visited the hospital emergency room after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had built in a friend’s yard. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She leaned over the bed and vomited.
Stephanie ultimately gave in. “I need to leave. I have to go home and use drugs.”
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 use once more. She thought she still had a month remaining to plan her recovery and deliver her child.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she left, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie had a infant weighing just over four pounds – early, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “not now.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been provided shortly before she gave birth.
She felt sick. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she relapsed. She felt without value, blaming herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her supplier would not provide to her when she became clearly expecting.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her bond with her newborn would make her stop using only led to increased guilt and self-abuse, a impetus for her to return to drugs. Yet she could not just wish 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 finally saw her her, she was connected to monitors, so little she thought she would break her. Embracing her at last, she felt nothing. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to name her baby 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 cared for jointly, not apart.
In much of the US, where a baby is diagnosed with infant withdrawal condition frequently, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a developing system of centers like this facility is demonstrating a key fact: when mothers and babies stay together, outcomes improve, foster placements fall and long-term costs decline.
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 left the medical center still in recovery, anxious and doubtful about what would come next.
At the care center, Stephanie still was concerned that CPS would come remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could walk in and separate them.
For the beginning period, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about getting by. Addiction came first; faith came last.
Stephanie had one close friend, but even that relationship was delicate. The those close to her always found ways to hurt her. She was unable to love herself, let alone anyone else.
Each day, staff from the center took her to a treatment center, provided orally. Slowly, she was starting to get clean.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed dietary support. She also had sensory challenges and required an occupational therapist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I found the strength. I could be a mom.
During a pre-holiday visit, Stephanie remained in the shared space, where parents in active addiction can come for guided meetings with their babies. An advocate, a mentor, visited with her own five kids in tow to deliver baked goods. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She holds a picture of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is slender. Her head is tilted forward so you do not see her expression. She is holding Izzie up on her knee for the other kids to see and they are crowding near, fawning and reaching out to the baby.
One child, eight, asked the mothers: “Where are all the dads?” The parents responded that the dads were busy, engaged elsewhere, that they would be there if possible.
“In the future,” 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. “If this little kid could see that newborns require care, then I could do this. I could parent.”
Approaches for managing infants affected by substances have existed for decades.
The evaluation method was created in 1975|
