A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
Eight months pregnant and in severe pain, the expectant mother arrived at the hospital emergency room after her infection worsened up her legs. Without a job or home, estranged from her family, she stayed in a makeshift shelter she had assembled in a friend’s yard. She was also dependent on fentanyl.
As physicians addressed her infection, she started to feel anxious. The onset of withdrawal began. She leaned over the bed and threw up.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had consumed opioids before coming to the ER 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 have this baby.
The medical professional intervened. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but medical staff detected she also had an amniotic fluid leak. The nurse, Izzie, 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 periodically, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie had a infant weighing 4lb 8oz – early, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been given four hours before delivery.
She felt ill. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she failed. She felt hopeless, criticizing herself for not being able to overcome the challenge. An OBGYN told her to “only” stop using. Even her supplier declined to supply to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The pervasive expectation that her love for her baby would make her quit only led to increased guilt and self-abuse, a trigger for her to return to drugs. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The infant was moved to the neonatal intensive care unit. When Stephanie finally saw her her, she was hooked up to monitors, so little she thought she would hurt her. Cradling her initially, she felt empty. “I gazed upon her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a new kind of care center where women and their babies are supported as a unit, not apart.
In numerous states, where a baby is found to have infant withdrawal condition regularly, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is showing an important truth: when families are kept intact, outcomes improve, fewer children enter care and overall savings increase.
It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, a couple of employees came to collect her.
She left the medical center still in detox, fearful and unsure about what would come next.
At Maddie’s Place, Stephanie still feared that CPS would come remove her daughter – even though she was not sure she wanted to keep her. The fear lingered: that at any time, someone could enter and remove her child.
For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about enduring. Substances came first; faith 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 value herself, let alone anyone else.
Every day, staff from the facility transported her to a recovery program, provided orally. Slowly, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed nutritional guidance. She also had sensory challenges and required an occupational therapist – all common issues for babies born with NAS.
Seeing that even a young person understands the need for care, then I was capable. I could be a mom.
One afternoon before Thanksgiving, Stephanie was in the common room, where those still using can come for supervised visits with their babies. A support specialist, a recovery coach, came over with her own children in tow to deliver baked goods. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is clad in casual attire, a gray knit hat with a decoration on her head, sitting on the wooden floor with the exit nearby. She is thin. Her head is tilted forward so you do not see her expression. She is holding Izzie up on her knee for the other kids to see and they are standing close, showing interest to the baby.
One child, eight, asked the moms: “What about the fathers?” The moms tried to explain that the men were occupied, handling responsibilities, that they would be there if they could.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist looked at each other. “I broke down,” Stephanie said. “If this little kid could see that infants need affection, then I could do this. I would become a mother.”
Tools for treating babies with exposure have been available for years.
The evaluation method was developed in 1975|
