She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, 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 resided in a small structure she had constructed in a friend’s yard. She was also addicted to fentanyl.
As doctors treated her infection, she started to feel anxious. The onset of withdrawal began. She leaned over the bed and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and get high.”
She had consumed opioids before seeking medical help and had only a brief window to get treated before she had to return to get high again. She thought she still had a month remaining to figure out how to get clean and deliver her child.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was critical, but physicians found she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is often prescribed in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie gave birth to a infant weighing a small weight – early, tiny yet healthy.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her pain relief did not work, her previous intake of fentanyl had been administered a few hours prior to birth.
She felt unwell. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she relapsed. She felt without value, berating herself for not being able to do the impossible. An OBGYN told her to “only” stop using. Even her dealer refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The pervasive expectation that her affection for her child would make her stop using only led to deeper self-loathing and negative self-talk, a impetus for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.
The infant was moved to the special care nursery. When Stephanie eventually visited her, she was attached to monitors, so tiny she thought she would harm her. Holding her for the first time, 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.
Two days later she decided to give her child the name after her caregiver, after the nurse who had been so kind to her.
Nurses and doctors told her about a specialized facility, a new kind of care center where mothers and their drug-exposed newborns are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with infant withdrawal condition frequently, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a small, growing network of centers like the care home is demonstrating a key fact: when parents and infants remain united, outcomes improve, fewer children enter care and long-term costs decline.
It took Stephanie a period to find strength to call, but she eventually made the call. After confirming she would be a good fit for the program, a couple of employees came to bring her to the facility.
She stepped out of the hospital still in withdrawal, scared and uncertain about what would come next.
At the care center, Stephanie still was concerned that authorities would come seize her child – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could enter and remove her child.
For the initial fortnight, Stephanie remained isolated. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about getting by. Substances came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to let her down. She was unable to value herself, let alone anyone else.
Daily, staff from Maddie’s Place drove her to a treatment center, administered in pill form. Gradually, she was beginning recovery.
She spent every minute beyond therapy 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 nutritional guidance. She also had heightened sensory issues and required an occupational therapist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I was capable. I could be a mom.
During a pre-holiday visit, Stephanie remained in the shared space, where parents in active addiction can come for monitored interactions with their babies. A support specialist, a mentor, visited with her own family in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in wonder of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She has an image of the moment. She is dressed in casual attire, a beanie with a pompom on her head, seated on the ground with the entryway at her back. She is lean. Her face is downcast so you cannot see her face. She is presenting her daughter on her knee for the young ones to see and they are standing close, showing interest to the baby.
One child, eight, asked the parents: “Where are all the dads?” The women attempted to clarify that the dads were busy, called away to other tasks, that they would be there if they could.
“When I have kids,” 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 made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I could be a mom.”
Approaches for managing babies with exposure have existed for decades.
The evaluation method was established in 1975|
