She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
Eight months pregnant and in severe pain, a woman named Stephanie visited the ER after her infection worsened up her legs. Unemployed and homeless, cut off from her relatives, she resided in a small structure she had constructed in a friend’s yard. She was also hooked on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and threw up.
Stephanie eventually collapsed. “I have to get out of here. 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 was compelled to leave to relapse. She thought she still had several weeks to find a way to become sober and deliver her child.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“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, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is often prescribed in rehabilitation.
After five days, on the 12th of November, Stephanie had a baby girl weighing a small weight – early, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been provided four hours before delivery.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she relapsed. She felt worthless, berating herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her dealer refused to sell to her when she became visibly pregnant.
“However, I failed,” she said. “I required assistance.”
The widespread belief that her affection for her child would make her stop using only led to greater shame and self-abuse, a impetus for her to return to drugs. Yet she could not simply will her addiction away, any more than she could eliminate a persistent condition.
The infant was moved to the special care nursery. When Stephanie at last met her, she was hooked up to monitors, so tiny she thought she would hurt her. Holding her for the first time, she felt nothing. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to call her daughter the same as her nurse, after the professional who provided support to her.
Medical personnel told her about a specialized facility, a unique recovery environment where parents and infants affected by substance use are treated together, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still rushed to special care and given drugs while their mothers face custody evaluations. But a developing system of centers like this facility is demonstrating a key fact: when parents and infants remain united, outcomes improve, custody cases decrease and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, a couple of employees came to collect her.
She departed the institution still in recovery, scared and uncertain about what would come next.
At Maddie’s Place, Stephanie still worried that child services would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any moment, someone could enter and take her baby away.
For the beginning period, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” 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 one close friend, but even that connection was tenuous. The people she loved always found ways to let her down. She did not know how to care for herself, let alone anyone else.
Each day, staff from the facility drove her to a clinic for methadone, administered in pill form. Gradually, she was starting to get clean.
She spent every minute when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed dietary support. She also had increased sensitivity and required an specialist – all common issues for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.
On a day prior to the holiday, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. Katie Bunch-Smith, a mentor, came over with her own family in tow to drop off cookies. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The young ones stared in wonder 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. None of those things mattered to them.”
She has an image of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a decoration on her head, sitting on the wooden floor with the exit nearby. She is slender. Her posture is humble so you do not see her expression. She is lifting the baby on her leg for the other kids to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the parents: “Why are there no men?” The moms tried to explain that the dads were busy, handling responsibilities, that they would be there given the chance.
“In the future,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
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 could do this. I would become a mother.”
Approaches for managing infants affected by substances have been used for a long time.
The evaluation method was developed in 1975|
