A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, a woman named Stephanie went to the hospital emergency room after an infection began spreading up her legs. Jobless and without shelter, estranged from her family, she lived in a shed she had built in a friend’s yard. She was also hooked on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and became sick.
Stephanie finally broke down. “I have to get out of here. I have to go home and use drugs.”
She had used fentanyl before seeking medical help and had only a brief window to get treated before she needed to go home to relapse. She thought she still had a month remaining to find a way to become sober and give birth.
The medical professional intervened. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was serious, but medical staff detected she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she walked out, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is often prescribed in addiction recovery.
Five days later, on 12 November 2022, Stephanie gave birth to a baby girl weighing just over four pounds – born before term, tiny yet healthy.
When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her anesthesia was ineffective, her last dose of fentanyl had been provided four hours before delivery.
She felt ill. Not ready for motherhood. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she relapsed. She felt worthless, blaming herself for not being able to overcome the challenge. An obstetrician told her to “only” 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 pervasive expectation that her bond with her newborn would make her quit only led to greater shame and negative self-talk, a trigger for her to use again. Yet she could not simply will her addiction away, any more than she could will away a persistent condition.
The infant was moved to the NICU. When Stephanie eventually visited her, she was attached to monitors, so small she thought she would hurt her. Embracing her at last, she felt nothing. “I gazed upon her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to call her daughter Izzie, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a unique recovery environment where women and their babies are cared for jointly, not apart.
In many parts of America, where a baby is identified with newborn addiction symptoms frequently, infants are still rushed to special care and medicated while their mothers face custody evaluations. But a developing system of centers like this facility is proving a simple point: when parents and infants remain united, outcomes improve, custody cases decrease and future expenses reduce.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility for the program, care providers came to pick her up.
She left the medical center still in detox, anxious and doubtful about what would come next.
At the care center, Stephanie still was concerned that CPS would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any point, someone could enter and remove her child.
For the first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about enduring. Drugs came first; reliance came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to let her down. She was unable to care for herself, much less anyone else.
Daily, staff from the center transported her to a recovery program, given as medication. Gradually, she was embracing sobriety.
She spent every minute outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and severe digestive problems. She needed feeding therapy. She also had increased sensitivity and required an occupational therapist – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I was capable. I could parent.
On a day prior to the holiday, Stephanie sat in the visitation area, where parents in active addiction can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, visited with her own family in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She has an image of the moment. She is wearing casual attire, a beanie with a bobble on her head, resting on the floor with the exit nearby. She is lean. Her posture is humble so you miss her features. She is lifting the baby on her knee for the young ones to see and they are standing close, admiring and touching to the baby.
One child, eight, asked the mothers: “Why are there no men?” The parents responded that the fathers had obligations, handling responsibilities, that they would be there if they could.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. 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 these babies deserve to be loved, then I could do this. I could parent.”
Tools for treating babies with exposure have been available for years.
The assessment tool was established in 1975|
