A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Transformed Their Futures.
Pregnant and experiencing intense discomfort, a woman named Stephanie arrived at the hospital emergency room after her infection worsened up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had built in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. The onset of withdrawal began. She slumped forward and threw up.
Stephanie ultimately gave in. “I need to leave. I have to go home and get high.”
She had used fentanyl before arriving at the hospital and had sufficient opportunity to get treated before she was compelled to leave to get high again. She thought she still had several weeks to plan her recovery and have this baby.
The medical professional intervened. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the leg infection was critical, but doctors had discovered 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.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is commonly used in substance abuse treatment.
After five days, on 12 November 2022, Stephanie had a daughter weighing a small weight – premature, small but alive.
When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her pain relief did not work, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Unworthy.
Stephanie had tried to get clean repeatedly before birth, and felt horrible each time she relapsed. She felt without value, berating herself for not being able to do the impossible. An obstetrician told her to “just” stop using. Even her dealer refused to sell to her when she became obviously with child.
“Yet I was unable,” she said. “I had to seek support.”
The common assumption that her affection for her child would make her stop using only led to increased guilt and self-harm, a impetus for her to return to drugs. Yet she could not just wish her addiction away, any more than she could eliminate a long-term illness.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was hooked up to tubes and leads, so small she thought she would hurt her. Cradling her initially, she felt empty. “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 after her caregiver, after the attendant who showed compassion to her.
Nurses and doctors told her about a specialized facility, a new kind of care center where parents and infants affected by substance use are supported as a unit, not apart.
In many parts of America, where a baby is found to have neonatal abstinence syndrome (NAS) regularly, 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 demonstrating a key fact: when families are kept intact, recovery succeeds, custody cases decrease and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, two staff members came to bring her to the facility.
She left the medical center still in recovery, anxious and doubtful about what would come next.
At the care center, Stephanie still worried that CPS would come seize her child – even though she was uncertain about motherhood. The fear lingered: that at any point, someone could enter and take her baby away.
For the first two weeks, Stephanie stayed withdrawn. “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; faith came last.
Stephanie had a trusted ally, but even that relationship was delicate. The those close to her always found ways to hurt her. She was unable to love herself, not to mention anyone else.
Every day, staff from the facility transported her to a recovery program, given as medication. Over time, she was starting to get clean.
She spent every minute outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed feeding therapy. She also had increased sensitivity and required an specialist – all typical problems for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a recovery coach, visited with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in wonder of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She holds a picture of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a decoration on her head, seated on the ground with the door behind her. She is thin. Her head is tilted forward so you cannot see her face. She is lifting the baby on her lap for the children to see and they are crowding near, showing interest to the baby.
A young boy, eight, asked the parents: “What about the fathers?” The moms tried to explain that the men were occupied, engaged elsewhere, that they would be there if possible.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist made eye contact. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I would become a mother.”
Methods to address drug-exposed newborns have existed for decades.
The evaluation method was developed in 1975|
