She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
Eight months pregnant and in severe pain, the expectant mother visited the ER 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 acquaintance's garden. She was also addicted to fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and became sick.
Stephanie ultimately gave in. “I need to leave. I have to go home and take a hit.”
She had taken the drug before arriving at the hospital and had only a brief window to get treated before she had to return to relapse. She thought she still had a month remaining to figure out how to get clean and give birth.
The medical professional intervened. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she departed, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is often prescribed in rehabilitation.
Five days later, on the 12th of November, Stephanie had a daughter weighing just over four pounds – early, tiny yet healthy.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her epidural had failed, her final administration of fentanyl had been given four hours before delivery.
She felt unwell. Ill-equipped for parenting. Undeserving.
Stephanie had sought recovery repeatedly before birth, and felt awful each time she relapsed. She felt without value, criticizing herself for not being able to achieve the unattainable. An OBGYN told her to “just” stop using. Even her dealer declined to supply to her when she became clearly expecting.
“But I couldn’t,” she said. “I needed help.”
The widespread belief that her affection for her child would make her recover only led to greater shame and self-abuse, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The baby was taken to the neonatal intensive care unit. When Stephanie finally saw her her, she was connected to monitors, so little she thought she would break her. Embracing her at last, she felt empty. “I gazed upon her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to name her baby after her caregiver, after the professional who provided support to her.
Nurses and doctors told her about a care center, a innovative treatment home where women and their babies are supported as a unit, not apart.
In many parts of America, where a baby is identified with neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a small, growing network of centers like this facility is demonstrating a key fact: when families are kept intact, results get better, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After confirming she would be a good fit for the program, care providers came to collect her.
She stepped out of the hospital still in detox, fearful and unsure about what would come next.
At the care center, Stephanie still was concerned that authorities would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any time, someone could enter and separate them.
For the initial fortnight, Stephanie remained isolated. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about enduring. Substances 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 hurt her. She lacked the ability to love herself, let alone anyone else.
Each day, staff from Maddie’s Place drove her to a clinic for methadone, provided orally. Slowly, she was embracing sobriety.
She devoted all her time when not in sessions 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 professional – all common issues for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. Katie Bunch-Smith, a recovery coach, came over with her own family in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in admiration of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She holds a picture of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a decoration on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her head is tilted forward so you miss her features. She is holding Izzie up on her knee for the other kids to see and they are gathered around, admiring and touching to the baby.
A young boy, eight, asked the mothers: “What about the fathers?” The parents responded that the dads were busy, called away to other tasks, that they would be there given the chance.
“In the future,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and Bunch-Smith exchanged glances. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that infants need affection, then I was able. I would become a mother.”
Approaches for managing drug-exposed newborns have been available for years.
The assessment tool was established in 1975|
