A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
In her eighth month of pregnancy and suffering, the expectant mother went to the ER after her infection worsened up her legs. Jobless and without shelter, cut off from her relatives, she stayed in a makeshift shelter she had constructed in a friend’s yard. She was also hooked on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Withdrawal was setting in. She bent over the bedside and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and get high.”
She had used fentanyl before coming to the ER and had sufficient opportunity to get treated before she was compelled to leave to use once more. She thought she still had four weeks left 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 medical facility declined to release her: the infection in her legs was critical, but medical staff detected she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she walked out, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
Five days later, on 12 November 2022, Stephanie delivered a infant weighing a small weight – premature, small but alive.
When the attendant inquired if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her anesthesia was ineffective, her final administration of fentanyl had been administered a few hours prior to birth.
She felt unwell. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt horrible each time she failed. She felt worthless, blaming herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her source refused to sell to her when she became clearly expecting.
“But I couldn’t,” she said. “I needed help.”
The pervasive expectation that her bond with her newborn would make her recover only led to deeper self-loathing and self-harm, a cause for her to use again. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The infant was moved to the neonatal intensive care unit. When Stephanie finally saw her her, she was hooked up to tubes and leads, so tiny she thought she would harm her. Holding her for the first time, she felt nothing. “I looked at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
After two days she decided to give her child the name 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 mothers and their drug-exposed newborns are treated together, not apart.
In many parts of America, where a baby is found to have neonatal abstinence syndrome (NAS) regularly, infants are still rushed to special care 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 parents and infants remain united, outcomes improve, fewer children enter care and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, two staff members came to collect her.
She stepped out of the hospital still in withdrawal, anxious and doubtful about what would come next.
At the care center, Stephanie still worried that child services would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any moment, someone could enter and separate them.
For the initial fortnight, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about getting by. Addiction came first; faith came last.
Stephanie had a single companion, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She lacked the ability to value herself, let alone anyone else.
Daily, staff from the center took her to a treatment center, given as medication. Slowly, she was embracing sobriety.
She spent every minute when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and severe digestive problems. She needed feeding therapy. She also had increased sensitivity and required an professional – all frequent conditions for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for guided meetings with their babies. Katie Bunch-Smith, a recovery coach, stopped by with her own children in tow to bring treats. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She has an image of the moment. She is clad in black pants and a hoodie, a beanie with a pompom on her head, resting on the floor with the door behind her. She is thin. Her face is downcast so you do not see her expression. She is presenting her daughter on her knee for the other kids to see and they are crowding near, fawning and reaching out to the baby.
A young boy, eight, asked the mothers: “Where are all the dads?” The women attempted to clarify that the men were occupied, handling responsibilities, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and the specialist made eye contact. “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 would become a mother.”
Methods to address infants affected by substances have existed for decades.
The Finnegan NAS scale was established in 1975|
