Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother visited the hospital emergency room after her infection worsened up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had assembled in a companion's property. She was also hooked on fentanyl.
As medical staff managed her infection, she began to panic. Withdrawal was setting in. She slumped forward and threw up.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”
She had used fentanyl before arriving at the hospital and had sufficient opportunity to get treated before she was compelled to leave to get high again. She thought she still had four weeks left to plan her recovery and deliver her child.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the infection in her legs was severe, but medical staff detected she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she departed, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in rehabilitation.
A short time later, on a day in November 2022, Stephanie had a daughter weighing just over four pounds – early, small but alive.
When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was numb. Her epidural had failed, her final administration of fentanyl had been given a few hours prior to birth.
She felt sick. Not ready for motherhood. Undeserving.
Stephanie had sought recovery multiple times while expecting, and felt horrible each time she relapsed. She felt without value, berating herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her source would not provide to her when she became obviously with child.
“However, I failed,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her recover only led to deeper self-loathing and negative self-talk, a cause 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 NICU. When Stephanie finally saw her her, she was attached to medical equipment, so small she thought she would hurt her. Holding her for the first time, she felt detached. “I looked at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to name her baby after her caregiver, after the nurse who had been so kind to her.
Medical personnel told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a developing system of centers like the care home is demonstrating a key fact: when parents and infants remain united, results get better, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After verifying her eligibility for the program, a couple of employees came to bring her to the facility.
She left the medical center still in recovery, scared and uncertain about what would happen next.
At the care center, Stephanie still worried that CPS would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any point, someone could walk in and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about survival. Drugs came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to hurt her. She did not know how to love herself, let alone anyone else.
Daily, staff from the facility took her to a recovery program, administered in pill form. 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 intolerance to some formulas and obvious stomach troubles. She needed nutritional guidance. She also had heightened sensory issues and required an specialist – all common issues for babies exposed to substances.
When a child recognizes these infants need affection, then I was capable. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where those still using can come for guided meetings with their babies. A support specialist, a recovery coach, stopped by with her own family in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration of the little newborn in Stephanie’s arms. “They had no care in the world,” 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 clad in black pants and a hoodie, a beanie with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is lean. Her head is tilted forward so you miss her features. She is lifting the baby on her knee for the other kids to see and they are standing close, admiring and touching to the baby.
Jacob, eight, asked the parents: “What about the fathers?” The parents responded that the men were occupied, engaged elsewhere, 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 the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I could parent.”
Tools for treating infants affected by substances have existed for decades.
The Finnegan NAS scale was created in 1975|
