She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
Eight months pregnant and in severe pain, a woman named Stephanie 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 friend’s yard. She was also hooked on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Withdrawal was setting in. 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 consumed opioids 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 several weeks to plan her recovery and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the doctors would not let her go: the leg infection was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in rehabilitation.
After five days, on 12 November 2022, Stephanie delivered a infant weighing a small weight – early, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her epidural had failed, her previous intake of fentanyl had been administered four hours before delivery.
She felt sick. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she was unsuccessful. She felt hopeless, criticizing herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her supplier declined to supply to her when she became visibly pregnant.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her bond with her newborn would make her recover only led to increased guilt 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 will away a long-term illness.
The baby was taken to the NICU. When Stephanie eventually visited her, she was connected to medical equipment, so little she thought she would hurt her. Cradling her initially, she felt empty. “I just stared at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to give her child the name Izzie, after the attendant who showed compassion to her.
Medical personnel told her about a care center, a innovative treatment home where women and their babies are treated together, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition regularly, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is showing an important truth: when families are kept intact, results get better, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After ensuring she qualified for the program, care providers came to pick her up.
She left the medical center still in detox, scared and uncertain about what would follow.
At Maddie’s Place, Stephanie still worried that CPS would come remove her daughter – 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 beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about getting by. Substances came first; trust came last.
Stephanie had a trusted ally, but even that connection was tenuous. The individuals she cared for always found ways to let her down. She did not know how to love herself, let alone anyone else.
Each day, staff from Maddie’s Place took her to a clinic for methadone, given as medication. Gradually, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an occupational therapist – all common issues for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I was capable. I could parent.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for supervised visits with their babies. An advocate, a mentor, came over with her own family in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in awe of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, seated on the ground with the exit nearby. She is slender. Her posture is humble so you do not see her expression. She is holding Izzie up on her knee for the young ones to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the parents: “Where are all the dads?” The women attempted to clarify that the dads were busy, handling responsibilities, that they would be there if possible.
“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and Bunch-Smith made eye contact. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I could do this. I would become a mother.”
Approaches for managing babies with exposure have been used for a long time.
The evaluation method was established in 1975|
