A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother went to the ER after a serious infection started to spread up her legs. Jobless and without shelter, estranged from her family, she resided in a small structure she had constructed in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and threw up.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and take a hit.”
She had consumed opioids before seeking medical help and had just enough time to get treated before she was compelled to leave to get high again. She thought she still had four weeks left to figure out how to get clean and deliver her child.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was serious, but medical staff detected she also had an ruptured membrane. The nurse, Izzie, warned her: if she walked out, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in rehabilitation.
After five days, on 12 November 2022, Stephanie had a baby girl weighing 4lb 8oz – born before term, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “I cannot.” She was detached. Her pain relief did not work, her last dose of fentanyl had been given a few hours prior to birth.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she was unsuccessful. She felt hopeless, berating herself for not being able to do the impossible. An OBGYN told her to “only” stop using. Even her dealer refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The widespread belief that her bond with her newborn would make her stop using only led to deeper self-loathing and negative self-talk, a cause for her to return to drugs. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was hooked up to medical equipment, so tiny she thought she would harm 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.
Following a brief period she decided to name her baby Izzie, after the attendant who showed compassion 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 found to have neonatal abstinence syndrome (NAS) regularly, 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 mothers and babies stay together, results get better, foster placements fall and future expenses reduce.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility for the program, a couple of employees came to collect her.
She left the medical center still in withdrawal, fearful and unsure about what would happen next.
At the facility, Stephanie still feared that authorities would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any point, someone could walk in and remove her child.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about survival. Addiction came first; trust came last.
Stephanie had a single companion, but even that connection was tenuous. The individuals she cared for always found ways to cause pain. She was unable to care for herself, not to mention anyone else.
Daily, staff from the center drove her to a treatment center, given as medication. Over time, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and obvious stomach troubles. She needed nutritional guidance. She also had increased sensitivity and required an specialist – all common issues for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I found the strength. I would become a mother.
During a pre-holiday visit, Stephanie was in the common room, where parents in active addiction can come for monitored interactions with their babies. Katie Bunch-Smith, a mentor, came over with her own five kids in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in awe of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She has an image of the moment. She is wearing casual attire, a cap with a pompom on her head, sitting on the wooden floor with the exit nearby. She is thin. Her face is downcast so you do not see her expression. She is holding Izzie up on her knee for the young ones to see and they are standing close, admiring and touching to the baby.
Jacob, eight, asked the moms: “What about the fathers?” The moms tried to explain that the men were occupied, handling responsibilities, that they would be there if they could.
“Once I become a parent,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and the specialist looked at each other. “I broke down,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I could do this. I could be a mom.”
Approaches for managing babies with exposure have existed for decades.
The assessment tool was created in 1975|
