A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the ER after a serious infection started to spread 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 physicians addressed her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie eventually collapsed. “I need to leave. I have to go home and use drugs.”
She had used fentanyl before seeking medical help and had sufficient opportunity to get treated before she was compelled to leave to get high again. She thought she still had several weeks to find a way to become sober and give birth.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was critical, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be transitioned to methadone, a medication that eases withdrawal and is commonly used in rehabilitation.
Five days later, on 12 November 2022, Stephanie had a baby girl weighing 4lb 8oz – born before term, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “not now.” She was numb. Her pain relief did not work, her final administration of fentanyl had been administered shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean repeatedly before birth, and felt awful each time she relapsed. She felt without value, blaming herself for not being able to do the impossible. An OBGYN told her to “simply” stop using. Even her supplier would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The widespread belief that her bond with her newborn would make her recover only led to increased guilt and self-harm, a trigger for her to relapse. Yet she could not simply will her addiction away, any more than she could will away a long-term illness.
The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was attached to tubes and leads, so little she thought she would break her. Holding her for the first time, she felt detached. “I gazed upon her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Nurses and doctors told her about a specialized facility, a new kind of care center where parents and infants affected by substance use 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 treated with pharmaceuticals while their mothers face child-protection investigations. But a small, growing network of centers like this facility is proving a simple point: when mothers and babies stay together, recovery succeeds, custody cases decrease and future expenses reduce.
It took Stephanie some time to build confidence to call, but she finally did. After verifying her eligibility for the program, two staff members came to bring her to the facility.
She left the medical center still in detox, scared and uncertain about what would happen next.
At the facility, Stephanie still feared that authorities would come remove her daughter – even though she was uncertain about motherhood. The fear lingered: that at any moment, someone could arrive and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I was suspicious at that point.”
Homelessness, she said, was about survival. Addiction came first; faith came last.
Stephanie had a single companion, but even that connection was tenuous. The individuals she cared for always found ways to hurt her. She lacked the ability to value herself, let alone anyone else.
Every day, staff from the center transported her to a treatment center, administered in pill form. Over time, she was beginning recovery.
She utilized each moment outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an specialist – all typical problems for babies born with NAS.
When a child recognizes these infants need affection, then I was capable. I would become a mother.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a recovery coach, came over with her own children in tow to deliver baked goods. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a pompom on her head, resting on the floor with the exit nearby. She is thin. Her face is downcast so you miss her features. She is lifting the baby on her leg for the children to see and they are standing close, admiring and touching to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The women attempted to clarify that the men were occupied, engaged elsewhere, that they would be there if possible.
“When I have kids,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and her companion looked at each other. “I just lost it and fell apart,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I could parent.”
Tools for treating babies with exposure have been used for a long time.
The assessment tool was developed in 1975|
