A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Transformed Their Futures.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the ER after a serious infection started to spread up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had constructed in a acquaintance's garden. She was also addicted to fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and threw up.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and use drugs.”
She had taken the drug before coming to the ER and had sufficient opportunity to get treated before she was compelled to leave to use once more. She thought she still had four weeks left to figure out how to get clean and have this baby.
The attending nurse disagreed. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she departed, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a drug that alleviates cravings and is often prescribed in addiction recovery.
Five days later, on a day in November 2022, Stephanie had a infant weighing 4lb 8oz – early, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was numb. Her epidural had failed, her previous intake of fentanyl had been given shortly before she gave birth.
She felt ill. Not ready for motherhood. Not fit.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she relapsed. She felt hopeless, blaming herself for not being able to achieve the unattainable. An doctor told her to “only” stop using. Even her source declined to supply to her when she became clearly expecting.
“But I couldn’t,” she said. “I required assistance.”
The pervasive expectation that her love for her baby would make her quit only led to deeper self-loathing and self-harm, a impetus for her to return to drugs. Yet she could not easily command her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was connected to medical equipment, so small she thought she would harm her. Embracing her at last, she felt detached. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Two days later she decided to name her baby Izzie, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a unique recovery environment where parents and infants affected by substance use are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition frequently, infants are still whisked to NICUs and given drugs while their mothers face child-protection investigations. But a small, growing network of centers like this facility is showing an important truth: when families are kept intact, recovery succeeds, foster placements fall and overall savings increase.
It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to pick her up.
She stepped out of the hospital still in withdrawal, fearful and unsure about what would happen next.
At the facility, Stephanie still worried that authorities would come remove her daughter – even though she was not sure she wanted to keep her. The fear lingered: that at any time, someone could arrive and take her baby away.
For the first two weeks, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” 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 a single companion, but even that relationship was delicate. The people she loved always found ways to hurt her. She was unable to love herself, not to mention anyone else.
Every day, staff from the center drove her to a recovery program, given as medication. Slowly, she was beginning recovery.
She devoted all her time when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and obvious stomach troubles. She needed feeding therapy. She also had increased sensitivity and required an specialist – all frequent conditions for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I was capable. I could parent.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where individuals struggling with substance use can come for monitored interactions with their babies. Katie Bunch-Smith, a mentor, stopped by with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in wonder of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a gray knit hat with a pompom on her head, sitting on the wooden floor with the exit nearby. She is lean. Her head is tilted forward so you cannot see her face. She is lifting the baby on her leg for the other kids to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the mothers: “Where are all the dads?” The women attempted to clarify that the fathers had obligations, engaged elsewhere, that they would be there if possible.
“When I have kids,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and Bunch-Smith made eye contact. “I became emotional,” Stephanie said. “When a child recognized that newborns require care, then I could do this. I would become a mother.”
Tools for treating infants affected by substances have been used for a long time.
The Finnegan NAS scale was created in 1975|