She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, the expectant mother went to the ER after her infection worsened up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had built in a acquaintance's garden. She was also dependent on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and vomited.
Stephanie finally broke down. “I need to leave. I have to go home and take a hit.”
She had taken the drug before seeking medical help and had only a brief window to get treated before she was compelled to leave to relapse. She thought she still had several weeks 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 am leaving,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but physicians found she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she left, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
After five days, on 12 November 2022, Stephanie delivered a infant weighing just over four pounds – premature, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was numb. Her pain relief did not work, her last dose of fentanyl had been administered four hours before delivery.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she was unsuccessful. She felt hopeless, criticizing herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her source would not provide to her when she became clearly expecting.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her affection for her child would make her quit only led to increased guilt and self-abuse, a cause for her to relapse. Yet she could not simply will her addiction away, any more than she could will away a persistent condition.
The newborn was transferred to the neonatal intensive care unit. When Stephanie eventually visited her, she was hooked up to medical equipment, so small she thought she would break her. Holding her for the first time, she felt detached. “I just stared at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to give her child the name the same as her nurse, after the professional who provided support to her.
Nurses and doctors told her about a specialized facility, a new kind of care center where mothers and their drug-exposed newborns are cared for jointly, not apart.
In numerous states, where a baby is found to have newborn addiction symptoms frequently, infants are still whisked to NICUs and given drugs while their mothers face custody evaluations. But a small, growing network of centers like the care home is showing an important truth: when mothers and babies stay together, results get better, custody cases decrease and future expenses reduce.
It took Stephanie a period to find strength to call, but she eventually made the call. After ensuring she qualified for the program, a couple of employees came to bring her to the facility.
She stepped out of the hospital still in withdrawal, fearful and unsure about what would come next.
At the facility, Stephanie still was concerned that child services would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any time, someone could walk in and remove her child.
For the first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about getting by. Drugs came first; reliance came last.
Stephanie had one close friend, but even that connection was tenuous. The individuals she cared for always found ways to cause pain. She was unable to value herself, much less anyone else.
Every day, staff from the facility transported her to a recovery program, provided orally. Over time, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and obvious stomach troubles. She needed nutritional guidance. She also had heightened sensory issues and required an occupational therapist – all typical problems for babies born with NAS.
When a child recognizes these infants need affection, then I was capable. I could be a mom.
On a day prior to the holiday, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, visited with her own children in tow to bring treats. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a cap with a decoration on her head, seated on the ground with the entryway at her back. She is lean. Her posture is humble so you do not see her expression. She is holding Izzie up on her lap for the children to see and they are gathered around, showing interest to the baby.
Jacob, eight, asked the parents: “Why are there no men?” The parents responded that the fathers had obligations, called away to other tasks, that they would be there if they could.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and her companion made eye contact. “I broke down,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I found the courage. I could be a mom.”
Approaches for managing drug-exposed newborns have been used for a long time.
The evaluation method was created in 1975|
