A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Transformed Their Futures.
Eight months pregnant and in severe pain, the expectant mother went to the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, cut off from her relatives, she lived in a shed she had built in a companion's property. She was also addicted to fentanyl.
As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and vomited.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and use drugs.”
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 four weeks left to plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was critical, but medical staff detected she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
Five days later, on a day in November 2022, Stephanie had a infant weighing just over four pounds – premature, small but alive.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been given a few hours prior to birth.
She felt ill. Ill-equipped for parenting. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she failed. She felt worthless, criticizing herself for not being able to achieve the unattainable. An obstetrician told her to “only” stop using. Even her dealer would not provide to her when she became clearly expecting.
“Yet I was unable,” she said. “I needed help.”
The widespread belief that her bond with her newborn would make her stop using only led to deeper self-loathing and self-abuse, a impetus for her to use again. Yet she could not easily command her addiction away, any more than she could overcome a long-term illness.
The infant was moved to the NICU. When Stephanie eventually visited her, she was hooked up to medical equipment, so little she thought she would harm her. Embracing her at last, she felt nothing. “I just stared at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the professional who provided support to her.
Medical personnel told her about a care center, a new kind of care center where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is found to have newborn addiction symptoms every 18 minutes, infants are still rushed to special care and given drugs 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, results get better, custody cases decrease and long-term costs decline.
It took Stephanie some time to build confidence to call, but she finally did. After ensuring she qualified for the program, two staff members came to bring her to the facility.
She departed the institution still in detox, anxious and doubtful about what would happen next.
At the care center, Stephanie still feared that child services would come remove her daughter – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could enter and remove her child.
For the first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about getting by. Addiction came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to let her down. She was unable to care for herself, much less anyone else.
Daily, staff from the center drove her to a clinic for methadone, provided orally. Slowly, she was beginning recovery.
She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and obvious stomach troubles. She needed nutritional guidance. She also had increased sensitivity and required an specialist – all common issues for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
On a day prior to the holiday, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own children in tow to drop off cookies. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She holds a picture of the moment. She is clad in casual attire, a cap 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 do not see her expression. She is presenting her daughter on her leg for the children to see and they are gathered around, admiring and touching to the baby.
A young boy, eight, asked the moms: “Where are all the dads?” The moms tried to explain that the fathers had obligations, called away to other tasks, that they would be there if they could.
“In the future,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I could be a mom.”
Tools for treating infants affected by substances have been available for years.
The Finnegan NAS scale was developed in 1975|
