A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Transformed Their Futures.
Eight months pregnant and in severe pain, a woman named Stephanie visited the medical facility after her infection worsened up her legs. Unemployed and homeless, separated from loved ones, she resided in a small structure she had assembled in a companion's property. She was also addicted to fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. 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 only a brief window to get treated before she was compelled to leave to relapse. She thought she still had four weeks left to figure out how to get clean and give birth.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was critical, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be placed on methadone, a treatment that reduces symptoms and is often prescribed in substance abuse treatment.
After five days, on 12 November 2022, Stephanie gave birth to a daughter weighing just over four pounds – premature, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was emotionless. Her epidural had failed, her previous intake of fentanyl had been administered a few hours prior to birth.
She felt unwell. Unprepared to be a mother. Unworthy.
Stephanie had tried to get clean repeatedly before birth, and felt awful each time she failed. She felt hopeless, criticizing herself for not being able to achieve the unattainable. An OBGYN told her to “simply” stop using. Even her supplier declined to supply to her when she became clearly expecting.
“But I couldn’t,” she said. “I required assistance.”
The widespread belief that her love for her baby would make her recover only led to increased guilt and self-abuse, a cause for her to use again. Yet she could not simply will her addiction away, any more than she could will away a persistent condition.
The infant was moved to the special care nursery. When Stephanie at last met her, she was attached to medical equipment, so small she thought she would hurt her. Cradling her initially, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to give her child the name after her caregiver, after the nurse who had been so kind to her.
Hospital staff told her about a specialized facility, a innovative treatment home where parents and infants affected by substance use are cared for jointly, not apart.
In much of the US, where a baby is diagnosed with infant withdrawal condition frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a limited but expanding group of centers like the care home is showing an important truth: when families are kept intact, recovery succeeds, fewer children enter care and overall savings increase.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After ensuring she qualified for the program, a couple of employees came to pick her up.
She departed the institution still in withdrawal, scared and uncertain about what would happen next.
At the care center, Stephanie still feared that child services would come remove her daughter – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could arrive and separate them.
For the beginning period, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Addiction came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to let her down. She lacked the ability to care for herself, not to mention anyone else.
Each day, staff from Maddie’s Place took her to a clinic for methadone, given as medication. Slowly, she was starting to get clean.
She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed dietary support. She also had sensory challenges and required an occupational therapist – all typical problems for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I was capable. I would become a mother.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where individuals struggling with substance use can come for guided meetings with their babies. Katie Bunch-Smith, a mentor, 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 children were wide-eyed in wonder of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She holds a picture of the moment. She is dressed in casual attire, a beanie with a bobble on her head, seated on the ground with the entryway at her back. She is slender. Her head is tilted forward so you cannot see her face. She is holding Izzie up on her leg for the children to see and they are crowding near, fawning and reaching out to the baby.
One child, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if they could.
“In the future,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and Bunch-Smith made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that newborns require care, then I was able. I would become a mother.”
Methods to address babies with exposure have existed for decades.
The Finnegan NAS scale was developed in 1975|
