She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie arrived at the hospital emergency room after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she stayed in a makeshift shelter she had constructed in a companion's property. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She slumped forward and vomited.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and take a hit.”
She had consumed opioids before coming to the ER and had just enough time to get treated before she was compelled to leave to use once more. She thought she still had several weeks to find a way to become sober and deliver her child.
The attending nurse disagreed. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the doctors would not let her go: the leg infection was severe, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
After five days, on a day in November 2022, Stephanie delivered a infant weighing a small weight – early, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her epidural had failed, her final administration of fentanyl had been administered four hours before delivery.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she failed. She felt hopeless, berating herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her dealer would not provide to her when she became visibly pregnant.
“Yet I was unable,” she said. “I required assistance.”
The widespread belief that her love for her baby would make her quit only led to deeper self-loathing and negative self-talk, a trigger for her to return to drugs. Yet she could not simply will her addiction away, any more than she could will away a long-term illness.
The newborn was transferred to the special care nursery. When Stephanie at last met her, she was connected to tubes and leads, so tiny she thought she would break her. Cradling her initially, she felt nothing. “I just stared at her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to give her child the name after her caregiver, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a new kind of care center where women and their babies are cared for jointly, not apart.
In many parts of America, where a baby is identified with newborn addiction symptoms every 18 minutes, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a limited but expanding group of centers like the care home is proving a simple point: when mothers and babies stay together, outcomes improve, foster placements fall and long-term costs decline.
It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, two staff members came to pick her up.
She stepped out of the hospital still in withdrawal, scared and uncertain about what would come next.
At the facility, Stephanie still was concerned that CPS would come seize her child – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could walk in and remove her child.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about getting by. Addiction came first; trust 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 lacked the ability to value herself, let alone anyone else.
Each day, staff from the facility transported her to a treatment center, given as medication. Over time, she was embracing sobriety.
She spent every minute outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with adverse reactions to milk and severe digestive problems. She needed feeding therapy. 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 found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. Katie Bunch-Smith, a recovery coach, came over with her own children in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the tiny infant 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 keeps a photo of the moment. She is wearing dark trousers and a sweatshirt, a beanie with a pompom on her head, seated on the ground with the entryway at her back. She is slender. Her head is tilted forward so you miss her features. She is lifting the baby on her leg for the young ones to see and they are standing close, admiring and touching to the baby.
A young boy, eight, asked the parents: “What about the fathers?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if possible.
“In the future,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that infants need affection, then I could do this. I could parent.”
Tools for treating drug-exposed newborns have been used for a long time.
The evaluation method was created in 1975|
