She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
In her eighth month of pregnancy and suffering, a woman named Stephanie arrived at the hospital emergency room after a serious infection started to spread up her legs. Without a job or home, separated from loved ones, she resided in a small structure she had constructed in a acquaintance's garden. She was also dependent on fentanyl.
As medical staff managed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She bent over the bedside and vomited.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and get high.”
She had consumed opioids before coming to the ER and had just enough time to get treated before she needed to go home to use once more. She thought she still had four weeks left to figure out how to get clean and deliver her child.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was critical, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she walked out, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a treatment that reduces symptoms and is frequently utilized in substance abuse treatment.
After five days, on a day in November 2022, Stephanie gave birth to a baby girl weighing 4lb 8oz – premature, little but surviving.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “not now.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been provided a few hours prior to birth.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she was unsuccessful. She felt worthless, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her dealer would not provide to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The common assumption that her bond with her newborn would make her quit only led to increased guilt and self-harm, a cause for her to return to drugs. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.
The infant was moved to the NICU. When Stephanie finally saw her her, she was attached to monitors, so tiny she thought she would break her. Cradling her initially, she felt nothing. “I gazed upon 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 give her child the name Izzie, after the professional who provided support to her.
Medical personnel told her about a care center, a innovative treatment home where women and their babies are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still whisked to NICUs and medicated while their mothers face child-protection investigations. But a developing system of centers like the care home is demonstrating a key fact: when families are kept intact, results get better, custody cases decrease and overall savings increase.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After ensuring she qualified for the program, care providers came to collect her.
She departed the institution still in detox, scared and uncertain about what would follow.
At Maddie’s Place, Stephanie still feared that authorities would come remove her daughter – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could walk in and separate them.
For the first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I was suspicious at that point.”
Homelessness, she said, was about survival. Addiction came first; reliance came last.
Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to let her down. She did not know how to value herself, much less anyone else.
Daily, staff from the center drove her to a treatment center, given as medication. Slowly, she was starting to get clean.
She spent every minute outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an specialist – all common issues for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie was in the common room, where parents in active addiction can come for guided meetings with their babies. An advocate, a mentor, visited with her own family in tow to drop off cookies. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She holds a picture of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a pompom on her head, seated on the ground with the exit nearby. She is thin. Her head is tilted forward so you miss her features. She is presenting her daughter on her knee for the young ones to see and they are crowding near, fawning and reaching out to the baby.
One child, eight, asked the moms: “Why are there no men?” The moms tried to explain that the men were occupied, engaged elsewhere, that they would be there if possible.
“In the future,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and her companion looked at each other. “I broke down,” Stephanie said. “If this little kid could see that newborns require care, then I could do this. I would become a mother.”
Methods to address infants affected by substances have been available for years.
The Finnegan NAS scale was created in 1975|
