She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, the expectant mother went to the hospital emergency room after an infection began spreading up her legs. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had assembled in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She leaned over the bed and became sick.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and take a hit.”
She had taken the drug before seeking medical help and had just enough time 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 deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was critical, but physicians found she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would face grave danger.
Izzie persuaded 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 switched to methadone, a medication that eases withdrawal and is frequently utilized in rehabilitation.
Five days later, on a day in November 2022, Stephanie had a infant weighing 4lb 8oz – early, tiny yet healthy.
When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her epidural had failed, her last dose of fentanyl had been provided a few hours prior to birth.
She felt ill. Not ready for motherhood. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt horrible each time she failed. She felt hopeless, blaming herself for not being able to achieve the unattainable. An obstetrician told her to “just” stop using. Even her supplier refused to sell to her when she became visibly pregnant.
“However, I failed,” she said. “I required assistance.”
The common assumption that her love for her baby would make her recover only led to deeper self-loathing and self-abuse, a impetus for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.
The baby was taken to the NICU. When Stephanie at last met her, she was attached to monitors, so little she thought she would hurt her. Cradling her initially, she felt detached. “I gazed upon her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to give her child the name the same as her nurse, after the professional who provided support to her.
Hospital staff told her about a specialized facility, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, 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 given drugs while their mothers face parental assessments. But a limited but expanding group of centers like this facility is proving a simple point: when parents and infants remain united, outcomes improve, fewer children enter care and long-term costs decline.
It took Stephanie some time to build confidence to call, but she finally did. After confirming she would be a good fit for the program, care providers came to bring her to the facility.
She departed the institution still in recovery, fearful and unsure about what would come next.
At the care center, Stephanie still feared that CPS would come take Izzie – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could walk in and remove her child.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about getting by. Drugs came first; reliance came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to cause pain. She did not know how to love herself, not to mention anyone else.
Each day, staff from the center took her to a treatment center, given as medication. Gradually, she was embracing sobriety.
She spent every minute outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with intolerance to some formulas and severe digestive problems. She needed dietary support. She also had increased sensitivity and required an occupational therapist – all common issues for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for monitored interactions with their babies. An advocate, a recovery coach, stopped by with her own family in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet 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. “My past did not matter to them. They focused only on the baby.”
She has an image of the moment. She is dressed in black pants and a hoodie, a gray knit hat with a decoration on her head, sitting on the wooden floor with the door behind her. She is thin. Her face is downcast so you miss her features. She is holding Izzie up on her leg for the young ones to see and they are standing close, admiring and touching to the baby.
One child, eight, asked the parents: “What about the fathers?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if they could.
“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. “Seeing that even youth understand that these babies deserve to be loved, then I was able. I could parent.”
Methods to address infants affected by substances have existed for decades.
The evaluation method was established in 1975|
