She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Transformed Their Futures.
In her eighth month of pregnancy and suffering, a woman named Stephanie visited the medical facility after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had constructed in a acquaintance's garden. She was also addicted to fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and vomited.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and use drugs.”
She had used fentanyl before coming to the ER and had only a brief window to get treated before she was compelled to leave to use once more. She thought she still had a month remaining to figure out how to get clean and deliver her child.
The attending nurse disagreed. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she left, she and her baby would not survive.
She encouraged the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.
A short time later, on 12 November 2022, Stephanie had a baby girl weighing a small weight – born before term, tiny yet healthy.
When the nurse asked if she wanted to embrace her child, Stephanie said “I cannot.” She was emotionless. Her epidural had failed, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt horrible each time she relapsed. She felt hopeless, blaming herself for not being able to overcome the challenge. An obstetrician told her to “just” stop using. Even her dealer declined to supply to her when she became obviously with child.
“Yet I was unable,” she said. “I required assistance.”
The widespread belief that her love for her baby would make her stop using only led to greater shame and negative self-talk, a cause for her to return to drugs. 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 NICU. When Stephanie at last met her, she was attached to monitors, so small she thought she would break her. Cradling her initially, she felt empty. “I just stared at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Medical personnel told her about a care center, a new kind of care center where mothers and their drug-exposed newborns are cared for jointly, not apart.
In numerous states, where a baby is identified with newborn addiction symptoms every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face custody evaluations. But a limited but expanding group of centers like the care home is showing an important truth: when parents and infants remain united, recovery succeeds, custody cases decrease and overall savings increase.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in detox, scared and uncertain about what would come next.
At the care center, Stephanie still was concerned that CPS would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any point, someone could walk in and take her baby away.
For the initial fortnight, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about enduring. Substances came first; reliance 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 did not know how to love herself, much less anyone else.
Every day, staff from the facility took her to a recovery program, given as medication. Gradually, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed dietary support. 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 could do this. I could be a mom.
During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for monitored interactions with their babies. A support specialist, a recovery coach, stopped by with her own children in tow to drop off cookies. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in admiration of the little newborn 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 has an image of the moment. She is wearing casual attire, a cap with a bobble on her head, resting on the floor with the entryway at her back. She is lean. Her face is downcast so you miss her features. She is lifting the baby on her knee for the young ones to see and they are crowding near, admiring and touching to the baby.
One child, eight, asked the moms: “Why are there no men?” The moms tried to explain that the men were occupied, called away to other tasks, that they would be there if they could.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that newborns require care, then I could do this. I could parent.”
Methods to address infants affected by substances have existed for decades.
The assessment tool was developed in 1975|
