A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother arrived at the medical facility after a serious infection started to spread up her legs. Jobless and without shelter, estranged from her family, she resided in a small structure she had assembled in a acquaintance's garden. She was also hooked on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Withdrawal was setting in. She slumped forward and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before coming to the ER and had only a brief window to get treated before she was compelled to leave to relapse. She thought she still had a month remaining to figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was severe, but physicians found she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would be at risk of death.
She encouraged 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 switched to methadone, a treatment that reduces symptoms and is often prescribed in rehabilitation.
Five days later, on a day in November 2022, Stephanie gave birth to a daughter weighing a small weight – born before term, small but alive.
When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been provided four hours before delivery.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety several times during pregnancy, and felt awful each time she was unsuccessful. She felt hopeless, berating herself for not being able to do the impossible. An doctor told her to “just” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“However, I failed,” she said. “I required assistance.”
The common assumption that her love for her baby would make her quit only led to greater shame and self-harm, a cause for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a persistent condition.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was attached to monitors, so small she thought she would hurt her. Cradling her initially, she felt empty. “I looked at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to call her daughter after her caregiver, after the nurse who had been so kind to her.
Medical personnel told her about a specialized facility, a new kind of care center where parents and infants affected by substance use are treated together, not apart.
In many parts of America, where a baby is found to have neonatal abstinence syndrome (NAS) frequently, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a developing system of centers like this facility is showing an important truth: when parents and infants remain united, recovery succeeds, custody cases decrease and overall savings increase.
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 pick her up.
She stepped out of the hospital still in detox, fearful and unsure about what would come next.
At the care center, Stephanie still was concerned that child services would come remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could enter and take her baby away.
For the first two weeks, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Drugs 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 was unable to care for herself, let alone anyone else.
Every day, staff from Maddie’s Place drove her to a clinic for methadone, provided orally. Over time, she was embracing sobriety.
She devoted all her time when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed dietary support. She also had sensory challenges and required an specialist – all common issues for babies exposed to substances.
When a child recognizes these infants need affection, then I found the strength. I could parent.
During a pre-holiday visit, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a mentor, visited with her own five kids in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She holds a picture of the moment. She is wearing casual attire, a cap with a pompom on her head, resting on the floor with the exit nearby. She is slender. Her face is downcast so you do not see her expression. She is lifting the baby on her lap for the young ones to see and they are gathered around, showing interest to the baby.
Jacob, eight, asked the parents: “What about the fathers?” The moms tried to explain that the men were occupied, handling responsibilities, that they would be there if possible.
“When I have kids,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I was able. I could parent.”
Methods to address drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was created in 1975|
