Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the medical facility after her infection worsened up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had assembled in a companion's property. She was also dependent on fentanyl.
As physicians addressed her infection, she started to feel anxious. The onset of withdrawal began. She leaned over the bed and became sick.
Stephanie eventually collapsed. “I need to leave. 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 get high again. She thought she still had four weeks left to plan her recovery and deliver her child.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was severe, but medical staff detected she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a drug that alleviates cravings and is commonly used in addiction recovery.
A short time later, on a day in November 2022, Stephanie had a daughter weighing a small weight – premature, small but alive.
When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been provided a few hours prior to birth.
She felt sick. Unprepared to be a mother. Unworthy.
Stephanie had tried to get clean several times during pregnancy, and felt terrible each time she relapsed. She felt worthless, criticizing herself for not being able to achieve the unattainable. An obstetrician told her to “simply” stop using. Even her source refused to sell to her when she became clearly expecting.
“However, I failed,” she said. “I needed help.”
The common assumption that her love for her baby would make her stop using only led to increased guilt and self-harm, a trigger for her to return to drugs. Yet she could not simply will her addiction away, any more than she could will away a chronic disease.
The newborn was transferred to the NICU. When Stephanie at last met her, she was connected to medical equipment, so little she thought she would break her. Cradling her initially, she felt nothing. “I just stared at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to name her baby Izzie, after the attendant who showed compassion to her.
Medical personnel 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 identified with neonatal abstinence syndrome (NAS) regularly, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a small, growing network of centers like the care home is proving a simple point: when parents and infants remain united, recovery succeeds, custody cases decrease and long-term costs decline.
It took Stephanie some time to build confidence to call, but she eventually made the call. After verifying her eligibility for the program, a couple of employees came to collect her.
She departed the institution still in recovery, 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 concern persisted: that at any time, someone could enter and take her baby away.
For the first two weeks, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about enduring. Addiction came first; reliance came last.
Stephanie had a trusted ally, but even that relationship was delicate. The people she loved always found ways to let her down. She lacked the ability to care for herself, not to mention anyone else.
Daily, staff from Maddie’s Place drove her to a recovery program, given as medication. Slowly, she was beginning recovery.
She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed nutritional guidance. She also had increased sensitivity and required an occupational therapist – all frequent conditions for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for guided meetings with their babies. Katie Bunch-Smith, a recovery coach, stopped by with her own family in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in wonder of the tiny infant 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 casual attire, a gray knit hat with a pompom on her head, seated on the ground with the exit nearby. She is lean. Her face is downcast so you cannot see her face. She is holding Izzie up on her lap for the other kids to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The parents responded that the fathers had obligations, engaged elsewhere, 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’m gonna show them that they deserve to be loved.”
Stephanie and her companion exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I could parent.”
Approaches for managing babies with exposure have existed for decades.
The evaluation method was developed in 1975|
