A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Transformed Their Futures.
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, estranged from her family, she lived in a shed she had assembled in a acquaintance's garden. She was also addicted to fentanyl.
As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. She bent over the bedside and became sick.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and get high.”
She had taken the drug before coming to the ER and had only a brief window to get treated before she was compelled to leave to use once more. She thought she still had a month remaining to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but medical staff detected she also had an ruptured membrane. The nurse, her nurse, warned her: if she left, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie controlled doses 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 often prescribed in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie had a daughter weighing 4lb 8oz – premature, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was emotionless. Her pain relief did not work, her last dose of fentanyl had been provided shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she relapsed. She felt hopeless, berating herself for not being able to achieve the unattainable. An OBGYN told her to “only” stop using. Even her supplier declined to supply to her when she became clearly expecting.
“However, I failed,” she said. “I had to seek support.”
The common assumption that her bond with her newborn would make her quit only led to greater shame and negative self-talk, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie at last met her, she was hooked up to monitors, so little she thought she would hurt her. Embracing her at last, she felt nothing. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to name her baby after her caregiver, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a innovative treatment home where parents and infants affected by substance use are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) regularly, infants are still rushed to special care and medicated while their mothers face parental assessments. But a limited but expanding group of centers like the care home is proving a simple point: when families are kept intact, outcomes improve, foster placements fall and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After confirming she would be a good fit for the program, a couple of employees came to bring her to the facility.
She departed the institution still in recovery, scared and uncertain about what would follow.
At Maddie’s Place, Stephanie still worried that CPS would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could walk in and take her baby away.
For the first two weeks, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about survival. Drugs came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to let her down. She was unable to care for herself, much less anyone else.
Daily, staff from the facility drove her to a clinic for methadone, administered in pill form. Over time, she was starting to get clean.
She utilized each moment when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed nutritional guidance. She also had sensory challenges and required an professional – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I found the strength. I could be a mom.
One afternoon before Thanksgiving, Stephanie was in the common room, where those still using can come for monitored interactions with their babies. A support specialist, a peer support specialist, came over with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” 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 gray knit hat with a bobble on her head, seated on the ground with the door behind her. She is lean. Her face is downcast so you cannot see her face. She is holding Izzie up on her knee for the other kids to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the mothers: “Why are there no men?” The parents responded that the fathers had obligations, handling responsibilities, that they would be there given the chance.
“In the future,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that infants need affection, then I was able. I could parent.”
Methods to address infants affected by substances have been available for years.
The evaluation method was created in 1975|
