She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Transformed Their Futures.
Pregnant and experiencing intense discomfort, the expectant mother went to the medical facility after her infection worsened up her legs. Jobless and without shelter, estranged from her family, 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 started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and vomited.
Stephanie finally broke down. “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 only a brief window 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 deliver her child.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the infection in her legs was severe, but medical staff detected she also had an ruptured membrane. The nurse, her nurse, warned her: if she left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be transitioned to methadone, a drug that alleviates cravings and is commonly used in rehabilitation.
A short time later, on 12 November 2022, Stephanie delivered a infant weighing a small weight – premature, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been given a few hours prior to birth.
She felt unwell. Not ready for motherhood. Not fit.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she relapsed. She felt without value, criticizing herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her dealer would not provide to her when she became clearly expecting.
“But I couldn’t,” she said. “I had to seek support.”
The common assumption that her love for her baby would make her stop using only led to greater shame and self-harm, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the NICU. When Stephanie finally saw her her, she was hooked up to monitors, so little she thought she would hurt her. Embracing her at last, she felt detached. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
After two days she decided to give her child the name Izzie, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a new kind of care center where parents and infants affected by substance use are supported as a unit, not apart.
In much of the US, where a baby is found to have infant withdrawal condition every 18 minutes, 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 showing an important truth: when mothers and babies stay together, outcomes improve, foster placements fall and long-term costs decline.
It took Stephanie some time to build confidence to call, but she finally did. After verifying her eligibility for the program, two staff members came to collect her.
She left the medical center still in recovery, anxious and doubtful about what would come next.
At Maddie’s Place, Stephanie still was concerned that authorities would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could arrive and take her baby away.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about survival. Drugs came first; reliance came last.
Stephanie had a single companion, but even that bond was fragile. The individuals she cared for always found ways to cause pain. She did not know how to value herself, much less anyone else.
Each day, staff from the facility drove her to a clinic for methadone, provided orally. Gradually, she was beginning recovery.
She utilized each moment outside treatment 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 pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an professional – all common issues for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I was capable. I would become a mother.
On a day prior to the holiday, Stephanie sat in the visitation area, where parents in active addiction can come for guided meetings with their babies. A support specialist, a mentor, stopped by with her own children in tow to deliver baked goods. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in admiration of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She has an image of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a pompom on her head, resting on the floor with the entryway at her back. She is lean. Her posture is humble so you cannot see her face. She is holding Izzie up on her lap for the young ones to see and they are crowding near, admiring and touching to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The parents responded that the dads were busy, called away to other tasks, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and her companion looked at each other. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I would become a mother.”
Tools for treating drug-exposed newborns have existed for decades.
The evaluation method was created in 1975|
