She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie visited the hospital emergency room 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 built in a friend’s yard. She was also hooked on fentanyl.
As doctors treated her infection, she began to panic. Withdrawal was setting in. She slumped forward and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and take a hit.”
She had taken the drug before coming to the ER and had just enough time to get treated before she had to return to get high again. She thought she still had a month remaining to figure out how to get clean and have this baby.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a medication that eases withdrawal and is often prescribed in addiction recovery.
A short time later, on a day in November 2022, Stephanie gave birth to a infant weighing 4lb 8oz – premature, small but alive.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her previous intake of fentanyl had been administered four hours before delivery.
She felt unwell. Unprepared to be a mother. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she was unsuccessful. She felt worthless, criticizing herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her source would not provide to her when she became clearly expecting.
“But I couldn’t,” she said. “I needed help.”
The pervasive expectation that her affection for her child would make her stop using only led to increased guilt and negative self-talk, a trigger for her to return to drugs. Yet she could not just wish her addiction away, any more than she could will away a long-term illness.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was connected to monitors, so small she thought she would break her. Holding her for the first time, she felt detached. “I looked at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to name her baby after her caregiver, after the professional who provided support to her.
Nurses and doctors told her about a care center, a new kind of care center where women and their babies are supported as a unit, not apart.
In many parts of America, where a baby is found to have newborn addiction symptoms frequently, infants are still rushed to special care and medicated while their mothers face parental assessments. But a developing system of centers like the care home is demonstrating a key fact: when families are kept intact, recovery succeeds, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength to call, but she ultimately reached out. After verifying her eligibility for the program, care providers came to pick her up.
She stepped out of the hospital still in withdrawal, anxious and doubtful about what would happen next.
At the facility, Stephanie still worried that child services would come take Izzie – even though she was hesitant about parenting. The concern persisted: that at any point, someone could walk in and separate them.
For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Drugs came first; reliance came last.
Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to cause pain. She was unable to care for herself, let alone anyone else.
Every day, staff from Maddie’s Place drove her to a recovery program, given as medication. Gradually, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was obtaining necessary support 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 sensory challenges and required an occupational therapist – all common issues for babies born with NAS.
Seeing that even a young person understands the need for care, then I was capable. I could be a mom.
On a day prior to the holiday, 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, came over with her own children in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in awe of the little newborn in Stephanie’s arms. “They showed no judgment,” 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 wearing casual attire, a beanie with a bobble on her head, sitting on the wooden floor with the exit nearby. She is lean. Her head is tilted forward so you cannot see her face. 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 parents: “Where are all the dads?” The women attempted to clarify that the fathers had obligations, called away to other tasks, that they would be there given the chance.
“When I have kids,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion exchanged glances. “I broke down,” Stephanie said. “If this little kid could see that newborns require care, then I was able. I could parent.”
Approaches for managing infants affected by substances have been used for a long time.
The evaluation method was established in 1975|
