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 visited the medical facility after an infection began spreading up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had constructed in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. The onset of withdrawal began. She bent over the bedside and became sick.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital 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 plan her recovery and give birth.
The medical professional intervened. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the leg infection was severe, but physicians found 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.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl at regular intervals, 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 often prescribed in rehabilitation.
After five days, on the 12th of November, Stephanie had a infant weighing just over four pounds – born before term, tiny yet healthy.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been given shortly before she gave birth.
She felt unwell. Not ready for motherhood. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt terrible each time she failed. She felt worthless, berating herself for not being able to achieve the unattainable. An obstetrician told her to “only” stop using. Even her dealer declined to supply to her when she became clearly expecting.
“Yet I was unable,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her stop using only led to increased guilt and self-abuse, a cause 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 baby was taken to the neonatal intensive care unit. When Stephanie finally saw her her, she was hooked up to medical equipment, so tiny she thought she would harm her. Holding her for the first time, she felt detached. “I gazed upon her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
After two days she decided to name her baby the same as her nurse, after the nurse who had been so kind to her.
Medical personnel told her about a specialized facility, a innovative treatment home where parents and infants affected by substance use are supported as a unit, not apart.
In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) regularly, infants are still quickly moved to hospitals and medicated while their mothers face parental assessments. But a small, growing network of centers like the care home is demonstrating a key fact: when parents and infants remain united, recovery succeeds, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, a couple of employees came to bring her to the facility.
She stepped out of the hospital still in recovery, scared and uncertain about what would come next.
At the care center, Stephanie still was concerned that child services would come seize her child – even though she was hesitant about parenting. The concern persisted: that at any moment, someone could enter and take her baby away.
For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”
Homelessness, she said, was about enduring. Substances came first; trust came last.
Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to let her down. She was unable to love herself, much less anyone else.
Each day, staff from the facility drove her to a treatment center, provided orally. Slowly, she was embracing sobriety.
She devoted all her time when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an occupational therapist – all frequent conditions for babies exposed to substances.
Seeing that even a young person understands the need for care, then I could do this. I could be a mom.
On a day prior to the holiday, Stephanie remained in the shared space, where parents in active addiction can come for guided meetings with their babies. A support specialist, a peer support specialist, came over with her own family in tow to bring treats. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The young ones stared 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 wearing black pants and a hoodie, a gray knit hat with a bobble on her head, seated on the ground with the exit nearby. She is thin. Her face is downcast so you do not see her expression. She is lifting the baby on her knee for the children to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the mothers: “Why are there no men?” The moms tried to explain that the fathers had obligations, engaged elsewhere, that they would be there if possible.
“In the future,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and the specialist made eye contact. “I broke down,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I could parent.”
Tools for treating babies with exposure have been available for years.
The evaluation method was created in 1975|
