She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
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 resided in a small structure she had built in a companion's property. She was also hooked on fentanyl.
As medical staff managed her infection, she began to panic. The onset of withdrawal began. She leaned over the bed and threw up.
Stephanie eventually collapsed. “I need to leave. I have to go home and take a hit.”
She had taken the drug before coming to the ER and had sufficient opportunity to get treated before she needed to go home to use once more. She thought she still had a month remaining to figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the medical facility declined to release 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 controlled doses of fentanyl periodically, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is commonly used in substance abuse treatment.
After five days, on a day in November 2022, Stephanie gave birth to a baby girl weighing 4lb 8oz – born before term, tiny yet healthy.
When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been given a few hours prior to birth.
She felt sick. Not ready for motherhood. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt horrible each time she relapsed. She felt without value, blaming herself for not being able to achieve the unattainable. An doctor told her to “only” stop using. Even her dealer declined to supply to her when she became clearly expecting.
“But I couldn’t,” she said. “I required assistance.”
The widespread belief that her bond with her newborn would make her quit only led to greater shame and self-harm, a cause for her to return to drugs. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The newborn was transferred to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to medical equipment, so tiny she thought she would hurt her. Cradling her initially, she felt detached. “I just stared at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to name her baby after her caregiver, after the attendant who showed compassion to her.
Medical personnel told her about a specialized facility, a unique recovery environment where parents and infants affected by substance use are treated together, not apart.
In much of the US, where a baby is found to have neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is demonstrating a key fact: when parents and infants remain united, results get better, foster placements fall and overall savings increase.
It took Stephanie a period to find strength to call, but she eventually made the call. After confirming she would be a good fit for the program, two staff members came to pick her up.
She left the medical center still in withdrawal, anxious and doubtful about what would come next.
At the care center, Stephanie still was concerned that authorities would come take Izzie – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could arrive and separate them.
For the beginning period, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Substances came first; reliance came last.
Stephanie had a trusted ally, but even that connection was tenuous. The those close to her always found ways to hurt her. She lacked the ability to care for herself, let alone anyone else.
Every day, staff from the center took her to a treatment center, administered in pill form. Gradually, she was beginning recovery.
She devoted all her time when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and obvious stomach troubles. She needed feeding therapy. She also had increased sensitivity and required an specialist – all typical problems for babies exposed to substances.
Seeing that even a young person understands the need for care, then I was capable. I could parent.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for guided meetings with their babies. An advocate, a peer support specialist, came over with her own children in tow to bring treats. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in wonder of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She keeps a photo of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a pompom on her head, resting on the floor with the door behind her. She is lean. Her head is tilted forward so you cannot see her face. She is lifting the baby on her leg for the young ones to see and they are standing close, fawning and reaching out to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The parents responded that the men were occupied, engaged elsewhere, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion looked at each other. “I just lost it and fell apart,” Stephanie said. “When a child recognized that infants need affection, then I was able. I could be a mom.”
Tools for treating drug-exposed newborns have been used for a long time.
The assessment tool was developed in 1975|
