She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Transformed Their Futures.
In her eighth month of pregnancy and suffering, a woman named Stephanie arrived at the hospital emergency room after a serious infection started to spread up her legs. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had built in a companion's property. She was also addicted to fentanyl.
As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and became sick.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and take a hit.”
She had used fentanyl before arriving at the hospital and had just enough time to get treated before she needed to go home to use once more. She thought she still had four weeks left to figure out how to get clean and have this baby.
The nurse had other ideas. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but physicians found she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in substance abuse treatment.
After five days, on the 12th of November, Stephanie gave birth to a daughter weighing a small weight – born before term, small but alive.
When the attendant inquired if she wanted to embrace her child, Stephanie said “not now.” She was numb. Her epidural had failed, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt ill. Not ready for motherhood. Undeserving.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she failed. She felt without value, berating herself for not being able to overcome the challenge. An obstetrician told her to “only” stop using. Even her supplier declined to supply to her when she became clearly expecting.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her recover only led to greater shame and negative self-talk, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could eliminate a persistent condition.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was connected to medical equipment, so tiny she thought she would break her. Embracing her at last, she felt detached. “I just stared at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to call her daughter the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about a care center, a unique recovery environment where parents and infants affected by substance use are treated together, not apart.
In numerous states, where a baby is identified with infant withdrawal condition frequently, infants are still whisked to NICUs and given drugs while their mothers face custody evaluations. But a developing system of centers like this facility is proving a simple point: when mothers and babies stay together, outcomes improve, custody cases decrease and future expenses reduce.
It took Stephanie some time to build confidence to call, but she eventually made the call. After ensuring she qualified for the program, two staff members came to pick her up.
She left the medical center still in recovery, scared and uncertain about what would follow.
At Maddie’s Place, Stephanie still feared that authorities would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any point, someone could arrive and take her baby away.
For the first two weeks, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about getting by. Drugs came first; faith came last.
Stephanie had one close friend, but even that relationship was delicate. The those close to her always found ways to let her down. She did not know how to care for herself, much less anyone else.
Each day, staff from the facility took her to a treatment center, administered in pill form. Over time, 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 daughter struggled with eating at first, with adverse reactions to milk and severe digestive problems. She needed dietary support. She also had increased sensitivity and required an occupational therapist – all typical problems for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I could do this. I could be a mom.
During a pre-holiday visit, Stephanie remained in the shared space, where those still using can come for guided meetings with their babies. An advocate, a peer support specialist, stopped by with her own family in tow to bring treats. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in awe of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She keeps a photo of the moment. She is wearing black pants and a hoodie, a gray knit hat with a decoration on her head, seated on the ground with the exit nearby. She is lean. Her posture is humble so you do not see her expression. She is presenting her daughter on her knee for the young ones to see and they are crowding near, admiring and touching to the baby.
A young boy, eight, asked the parents: “Why are there no men?” The women attempted to clarify that the men were occupied, called away to other tasks, that they would be there if possible.
“Once I become a parent,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and her companion looked at each other. “I broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I could do this. I could parent.”
Approaches for managing babies with exposure have existed for decades.
The assessment tool was developed in 1975|
