She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
Eight months pregnant and in severe pain, a woman named Stephanie went to the medical facility after her infection worsened up her legs. Unemployed and homeless, cut off from her relatives, she lived in a shed she had assembled in a companion's property. She was also hooked on fentanyl.
As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. She bent over the bedside and vomited.
Stephanie eventually collapsed. “I need to leave. I have to go home and get high.”
She had used fentanyl before arriving at the hospital and had sufficient opportunity to get treated before she had to return to get high again. She thought she still had four weeks left to plan her recovery and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the leg infection was critical, but physicians found she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that abstinence might harm her and the baby. After delivery Stephanie would be transitioned to methadone, a medication that eases withdrawal and is commonly used in addiction recovery.
A short time later, on 12 November 2022, Stephanie gave birth to a daughter weighing just over four pounds – early, small but alive.
When the nurse asked if she wanted to embrace her child, Stephanie said “I cannot.” She was numb. Her epidural had failed, her previous intake of fentanyl had been provided shortly before she gave birth.
She felt ill. Unprepared to be a mother. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt awful each time she relapsed. She felt without value, berating herself for not being able to achieve the unattainable. An obstetrician told her to “just” stop using. Even her source would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The widespread belief that her love for her baby would make her stop using only led to increased guilt and negative self-talk, a impetus for her to return to drugs. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The infant was moved to the NICU. When Stephanie finally saw her her, she was attached to medical equipment, so little she thought she would break her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to name her baby after her caregiver, after the professional who provided support to her.
Medical personnel told her about a care center, a innovative treatment home where parents and infants affected by substance use are treated together, not apart.
In many parts of America, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a developing system of centers like this facility is showing an important truth: when mothers and babies stay together, recovery succeeds, custody cases decrease and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After confirming she would be a good fit for the program, care providers came to collect her.
She departed the institution still in detox, scared and uncertain about what would follow.
At the facility, Stephanie still worried that authorities would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any point, someone could arrive and separate them.
For the initial fortnight, Stephanie remained isolated. “I avoided interaction,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about getting by. Substances came first; reliance came last.
Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to let her down. She was unable to value herself, much less anyone else.
Each day, staff from Maddie’s Place transported her to a recovery program, administered in pill form. Over time, she was beginning recovery.
She spent every minute when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed dietary support. She also had increased sensitivity and required an professional – all frequent conditions for babies exposed to substances.
When a child recognizes these infants need affection, then I found the strength. I could parent.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for monitored interactions with their babies. An advocate, a mentor, stopped by with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She has an image of the moment. She is dressed in casual attire, a beanie with a pompom on her head, sitting on the wooden floor with the exit nearby. She is thin. Her head is tilted forward so you cannot see her face. 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.
Jacob, eight, asked the moms: “Why are there no men?” The women attempted to clarify that the fathers had obligations, handling responsibilities, that they would be there if they could.
“In the future,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and Bunch-Smith exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I could parent.”
Tools for treating drug-exposed newborns have existed for decades.
The Finnegan NAS scale was developed in 1975|
