She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie arrived at the ER after an infection began spreading up her legs. Without a job or home, estranged from her family, she resided in a small structure she had built in a acquaintance's garden. She was also hooked on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She slumped forward and became sick.
Stephanie eventually collapsed. “I need to leave. I have to go home and get high.”
She had used fentanyl before seeking medical help and had sufficient opportunity to get treated before she had to return to relapse. She thought she still had a month remaining to figure out how to get clean and deliver her child.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the doctors would not let her go: the infection in her legs was serious, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is often prescribed in addiction recovery.
After five days, on the 12th of November, Stephanie gave birth to a baby girl weighing a small weight – premature, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her pain relief did not work, her final administration of fentanyl had been administered four hours before delivery.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she relapsed. She felt hopeless, blaming herself for not being able to do the impossible. An doctor told her to “only” stop using. Even her dealer would not provide to her when she became clearly expecting.
“But I couldn’t,” she said. “I had to seek support.”
The common assumption that her love for her baby would make her stop using only led to deeper self-loathing and negative self-talk, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could overcome a long-term illness.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was connected to medical equipment, so small she thought she would hurt her. Cradling her initially, she felt nothing. “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 the same as her nurse, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In much of the US, where a baby is found to have infant withdrawal condition frequently, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a small, growing network of centers like this facility is proving a simple point: when mothers and babies stay together, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie a period to find strength to call, but she eventually made the call. After confirming she would be a good fit for the program, a couple of employees came to collect her.
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 remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could arrive and separate them.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about survival. Addiction came first; trust came last.
Stephanie had a single companion, but even that connection was tenuous. The those close to her always found ways to hurt her. She lacked the ability to love herself, let alone anyone else.
Each day, staff from the center took her to a recovery program, administered in pill form. Gradually, she was starting to get clean.
She spent every minute outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed nutritional guidance. She also had heightened sensory issues and required an specialist – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where parents in active addiction can come for supervised visits with their babies. An advocate, a mentor, stopped by with her own children in tow to bring treats. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She has an image of the moment. She is wearing dark trousers and a sweatshirt, a cap with a decoration on her head, sitting on the wooden floor with the exit nearby. She is thin. Her posture is humble so you cannot see her face. 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.
A young boy, eight, asked the parents: “What about the fathers?” The women attempted to clarify that the fathers had obligations, called away to other tasks, that they would be there if they could.
“In the future,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist looked at each other. “I became emotional,” Stephanie said. “When a child recognized that newborns require care, then I could do this. I could be a mom.”
Approaches for managing babies with exposure have been used for a long time.
The assessment tool was created in 1975|
