A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Transformed Their Futures.
Pregnant and experiencing intense discomfort, the expectant mother went to the medical facility after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she stayed in a makeshift shelter she had built in a acquaintance's garden. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She slumped forward and threw up.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and get high.”
She had consumed opioids before seeking medical help and had just enough time to get treated before she had to return to relapse. 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 not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but physicians found she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.
A short time later, on 12 November 2022, Stephanie gave birth to a daughter weighing 4lb 8oz – early, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was detached. Her pain relief did not work, her final administration of fentanyl had been given shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Undeserving.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she failed. She felt worthless, blaming herself for not being able to overcome the challenge. An obstetrician told her to “only” stop using. Even her source would not provide to her when she became clearly expecting.
“Yet I was unable,” she said. “I needed help.”
The common assumption that her bond with her newborn would make her recover only led to increased guilt and self-abuse, a trigger for her to use again. Yet she could not just wish her addiction away, any more than she could eliminate a chronic disease.
The newborn was transferred to the neonatal intensive care unit. When Stephanie finally saw her her, she was connected to monitors, so tiny she thought she would hurt her. Cradling her initially, she felt nothing. “I just stared at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the professional who provided support to her.
Medical personnel told her about a specialized facility, a new kind of care center where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition regularly, infants are still rushed to special care and given drugs while their mothers face parental assessments. But a small, growing network of centers like this facility is showing an important truth: when mothers and babies stay together, outcomes improve, fewer children enter care and long-term costs decline.
It took Stephanie a period to find strength to call, but she ultimately reached out. After verifying her eligibility for the program, care providers came to pick her up.
She stepped out of the hospital still in detox, scared and uncertain about what would happen next.
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 moment, someone could arrive and separate them.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about survival. Substances 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 care for herself, not to mention anyone else.
Every day, staff from the facility transported her to a recovery program, provided orally. Gradually, she was beginning recovery.
She spent every minute 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 dietary support. She also had heightened sensory issues and required an occupational therapist – all common issues for babies born with NAS.
When a child recognizes these infants need affection, then I was capable. I could parent.
On a day prior to the holiday, Stephanie remained in the shared space, where parents in active addiction can come for monitored interactions with their babies. A support specialist, a peer support specialist, came over with her own family in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They had no care in the world,” 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 cap with a decoration on her head, seated on the ground with the entryway at her back. She is slender. Her head is tilted forward so you miss her features. She is presenting her daughter on her leg for the other kids to see and they are crowding near, showing interest to the baby.
Jacob, eight, asked the parents: “Why are there no men?” The women attempted to clarify that the dads were busy, handling responsibilities, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and the specialist made eye contact. “I became emotional,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I was able. I could be a mom.”
Methods to address infants affected by substances have been available for years.
The assessment tool was established in 1975|