She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
Pregnant and experiencing intense discomfort, a woman named Stephanie arrived at the hospital emergency room after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she resided in a small structure she had built in a friend’s yard. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and vomited.
Stephanie eventually collapsed. “I need to leave. I have to go home and use drugs.”
She had taken the drug before coming to the ER and had sufficient opportunity to get treated before she needed to go home to get high again. She thought she still had four weeks left to find a way to become sober and give birth.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the doctors would not let her go: the leg infection was critical, but doctors had discovered she also had an ruptured membrane. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.
A short time later, on 12 November 2022, Stephanie delivered a infant weighing a small weight – born before term, small but alive.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been given a few hours prior to birth.
She felt ill. Ill-equipped for parenting. Undeserving.
Stephanie had sought recovery multiple times while expecting, and felt horrible each time she was unsuccessful. She felt hopeless, criticizing herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“However, I failed,” she said. “I required assistance.”
The widespread belief that her affection for her child would make her quit only led to greater shame and self-abuse, a cause for her to use again. Yet she could not simply will her addiction away, any more than she could will away a long-term illness.
The infant was moved to the NICU. When Stephanie finally saw her her, she was connected to monitors, so tiny she thought she would hurt her. Holding her for the first time, she felt nothing. “I just stared at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to name her baby after her caregiver, after the attendant who showed compassion 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 identified with newborn addiction symptoms frequently, infants are still rushed to special care and given drugs while their mothers face parental assessments. But a developing system of centers like the care home is proving a simple point: when mothers and babies stay together, outcomes improve, fewer children enter care and long-term costs decline.
It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to collect her.
She departed the institution still in detox, anxious and doubtful about what would come next.
At the care center, Stephanie still worried that child services would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any time, someone could enter and take her baby away.
For the first two weeks, Stephanie remained isolated. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Drugs came first; faith 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, not to mention anyone else.
Every day, staff from the facility drove her to a recovery program, administered in pill form. Slowly, she was starting to get clean.
She devoted all her time 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 heightened sensory issues and required an occupational therapist – all common issues for babies born with NAS.
Seeing that even a young person understands the need for care, then I was capable. I could parent.
During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for guided meetings with their babies. A support specialist, a recovery coach, stopped by with her own family in tow to deliver baked goods. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in admiration 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 holds a picture of the moment. She is clad in black pants and a hoodie, a gray knit hat with a decoration on her head, resting on the floor with the exit nearby. She is slender. Her posture is humble so you do not see her expression. She is presenting her daughter on her leg for the children to see and they are crowding near, fawning and reaching out to the baby.
One child, eight, asked the mothers: “What about the fathers?” The women attempted to clarify that the men were occupied, called away to other tasks, that they would be there if possible.
“Once I become a parent,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and Bunch-Smith made eye contact. “I became emotional,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I would become a mother.”
Methods to address babies with exposure have existed for decades.
The evaluation method was created in 1975|
