She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother arrived at the ER after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she lived in a shed she had assembled in a acquaintance's garden. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. 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 get high.”
She had consumed opioids before arriving at the hospital and had sufficient opportunity to get treated before she was compelled to leave to relapse. She thought she still had several weeks to find a way to become sober and have this baby.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was severe, but doctors had discovered she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be switched to methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
A short time later, on 12 November 2022, Stephanie delivered a baby girl weighing just over four pounds – early, small but alive.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was detached. Her pain relief did not work, her last dose of fentanyl had been provided shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Undeserving.
Stephanie had sought recovery repeatedly before birth, and felt awful each time she was unsuccessful. She felt hopeless, blaming herself for not being able to achieve the unattainable. An obstetrician told her to “simply” stop using. Even her dealer refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The pervasive expectation that her love for her baby would make her stop using only led to greater shame and negative self-talk, a impetus 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 infant was moved to the special care nursery. When Stephanie at last met her, she was connected to tubes and leads, so little she thought she would hurt her. Embracing her at last, she felt detached. “I looked at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to call her daughter the same as her nurse, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a innovative treatment home where women and their babies are treated together, not apart.
In much of the US, where a baby is identified with infant withdrawal condition frequently, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a limited but expanding group of centers like this facility is demonstrating a key fact: when parents and infants remain united, results get better, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength to call, but she ultimately reached out. After confirming she would be a good fit for the program, care providers came to bring her to the facility.
She left the medical center still in recovery, anxious and doubtful about what would happen next.
At the facility, Stephanie still worried that child services would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any point, someone could arrive and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about survival. Substances came first; faith came last.
Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to hurt her. She did not know how to care for herself, much less anyone else.
Every day, staff from Maddie’s Place took her to a clinic for methadone, provided orally. Over time, she was starting to get clean.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had heightened sensory issues and required an specialist – all common issues for babies born with NAS.
Seeing that even a young person understands the need for care, then I was capable. I would become a mother.
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. Katie Bunch-Smith, a mentor, stopped by with her own children in tow to drop off cookies. 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 showed no judgment,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She has an image of the moment. She is wearing dark trousers and a sweatshirt, a beanie with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is slender. Her face is downcast so you cannot see her face. She is holding Izzie up on her lap for the children to see and they are crowding near, showing interest to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The parents responded that the men were occupied, handling responsibilities, that they would be there if possible.
“When I have kids,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I would become a mother.”
Tools for treating babies with exposure have existed for decades.
The Finnegan NAS scale was developed in 1975|
