A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
Eight months pregnant and in severe pain, the expectant mother went to the ER after an infection began spreading up her legs. Without a job or home, separated from loved ones, she resided in a small structure she had built in a acquaintance's garden. She was also dependent on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and threw up.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and get high.”
She had taken the drug before seeking medical help and had only a brief window to get treated before she had to return to use once more. 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.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the leg infection was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is often prescribed in substance abuse treatment.
A short time later, on 12 November 2022, Stephanie had a baby girl weighing 4lb 8oz – born before term, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was detached. Her anesthesia was ineffective, her final administration of fentanyl had been given shortly before she gave birth.
She felt sick. Not ready for motherhood. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she failed. She felt hopeless, blaming herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her source declined to supply to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The pervasive expectation that her love for her baby would make her quit 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 overcome a long-term illness.
The baby was taken to the neonatal intensive care unit. When Stephanie at last met her, she was connected to monitors, so tiny she thought she would break her. Embracing her at last, she felt nothing. “I looked at her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
After two days she decided to give her child the name the same as her nurse, after the nurse who had been so kind to her.
Medical personnel told her about a care center, a unique recovery environment where women and their babies 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 quickly moved to hospitals and given drugs while their mothers face parental assessments. But a limited but expanding group of centers like the care home is showing an important truth: when mothers and babies stay together, outcomes improve, custody cases decrease and future expenses reduce.
It took Stephanie a period to find strength to call, but she ultimately reached out. After confirming she would be a good fit for the program, care providers came to pick her up.
She stepped out of the hospital still in detox, scared and uncertain about what would come next.
At the care center, Stephanie still worried that CPS would come remove her daughter – even though she was uncertain about motherhood. The concern persisted: that at any time, someone could enter and take her baby away.
For the beginning period, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about getting by. Drugs came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to cause pain. She did not know how to love herself, much less anyone else.
Daily, staff from the facility took her to a clinic for methadone, provided orally. Slowly, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had heightened sensory issues and required an occupational therapist – all common issues for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I was capable. I could be a mom.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. A support specialist, a recovery coach, stopped by with her own five kids in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The young ones stared in admiration 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 black pants and a hoodie, a beanie with a pompom on her head, resting on the floor with the door behind her. She is slender. Her face is downcast so you do not see her expression. She is holding Izzie up on her lap for the young ones 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 parents responded that the dads were busy, engaged elsewhere, that they would be there if they could.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I found the courage. I would become a mother.”
Approaches for managing babies with exposure have been available for years.
The evaluation method was created in 1975|
