She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
Eight months pregnant and in severe pain, 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, cut off from her relatives, she stayed in a makeshift shelter she had built in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and became sick.
Stephanie finally broke down. “I have to get out of here. I have to go home and take a hit.”
She had used fentanyl before seeking medical help and had only a brief window to get treated before she was compelled to leave to use once more. She thought she still had a month remaining to plan her recovery and deliver her child.
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 leg infection was severe, but physicians found she also had an ruptured membrane. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be switched to methadone, a drug that alleviates cravings and is commonly used in addiction recovery.
After five days, on 12 November 2022, Stephanie gave birth to a infant weighing just over four pounds – early, little but surviving.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been given shortly before she gave birth.
She felt sick. Not ready for motherhood. Unworthy.
Stephanie had sought recovery several times during pregnancy, and felt horrible each time she was unsuccessful. She felt worthless, berating herself for not being able to achieve the unattainable. An OBGYN told her to “only” stop using. Even her source would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The widespread belief that her love for her baby would make her stop using only led to deeper self-loathing and self-abuse, a impetus for her to relapse. Yet she could not just wish her addiction away, any more than she could overcome a chronic disease.
The newborn was transferred to the NICU. When Stephanie at last met her, she was connected to monitors, so little she thought she would break her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to give her child the name after her caregiver, after the professional who provided support to her.
Medical personnel told her about a care center, a unique recovery environment where parents and infants affected by substance use are cared for jointly, not apart.
In much of the US, where a baby is found to have newborn addiction symptoms frequently, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like this facility is showing an important truth: when families are kept intact, recovery succeeds, fewer children enter care and long-term costs decline.
It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in detox, scared and uncertain about what would follow.
At the care center, Stephanie still feared that authorities would come take Izzie – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could arrive and remove her child.
For the first two weeks, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about survival. Substances came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to hurt her. She lacked the ability to care for herself, not to mention anyone else.
Each day, staff from the center transported her to a recovery program, given as medication. Over time, she was embracing sobriety.
She devoted all her time when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed dietary support. She also had increased sensitivity and required an occupational therapist – all common issues for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, came over with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in admiration of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is clad in dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, resting on the floor with the door behind her. She is slender. Her posture is humble so you do not see her expression. She is lifting the baby on her leg for the young ones to see and they are gathered around, showing interest to the baby.
A young boy, eight, asked the mothers: “Where are all the dads?” The parents responded that the dads were busy, called away to other tasks, that they would be there given the chance.
“In the future,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and the specialist exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I could be a mom.”
Tools for treating infants affected by substances have been used for a long time.
The evaluation method was developed in 1975|
