A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother arrived at the hospital emergency room after an infection began spreading up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had built in a friend’s yard. She was also addicted to fentanyl.
As physicians addressed her infection, she began to panic. Symptoms of withdrawal emerged. She leaned over the bed and vomited.
Stephanie finally broke down. “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 needed to go home to get high again. She thought she still had several weeks to find a way to become sober and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was serious, but physicians found she also had an ruptured membrane. The nurse, her nurse, warned her: if she walked out, she and her baby would be at risk of death.
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 placed on methadone, a drug that alleviates cravings and is commonly used in rehabilitation.
A short time later, on 12 November 2022, Stephanie delivered a daughter weighing a small weight – born before term, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “not now.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been provided a few hours prior to birth.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery several times during pregnancy, and felt horrible each time she relapsed. She felt hopeless, criticizing herself for not being able to achieve the unattainable. An OBGYN told her to “simply” stop using. Even her dealer would not provide to her when she became obviously with child.
“Yet I was unable,” she said. “I needed help.”
The common assumption that her affection for her child would make her recover only led to increased guilt and self-harm, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie at last met her, she was connected to tubes and leads, so tiny she thought she would break her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to name her baby Izzie, after the professional who provided support to her.
Hospital staff told her about a specialized facility, a new kind of care center where women and their babies are supported as a unit, not apart.
In much of the US, where a baby is diagnosed 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 showing an important truth: when parents and infants remain united, outcomes improve, custody cases decrease 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, fearful and unsure about what would come next.
At the facility, Stephanie still worried that CPS would come remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any moment, someone could walk in and remove her child.
For the first two weeks, Stephanie stayed withdrawn. “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 connection was tenuous. The individuals she cared for always found ways to hurt her. She did not know how to value herself, not to mention anyone else.
Daily, staff from the facility drove her to a recovery program, given as medication. Gradually, she was starting to get clean.
She devoted all her time 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 feeding therapy. She also had sensory challenges and required an occupational therapist – all typical problems for babies exposed to substances.
Seeing that even a young person understands the need for care, then I was capable. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where parents in active addiction can come for guided meetings with their babies. An advocate, a peer support specialist, came over with her own family in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in wonder of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She keeps a photo of the moment. She is clad in dark trousers and a sweatshirt, a cap with a decoration on her head, resting on the floor with the entryway at her back. She is slender. Her face is downcast so you cannot see her face. She is presenting her daughter on her knee for the young ones to see and they are gathered around, showing interest to the baby.
One child, eight, asked the mothers: “Why are there no men?” The parents responded that the men were occupied, called away to other tasks, that they would be there if possible.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist looked at each other. “I broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I was able. I could parent.”
Approaches for managing infants affected by substances have been used for a long time.
The evaluation method was created in 1975|
