A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Rescued Both Lives.
Pregnant and experiencing intense discomfort, a woman named Stephanie visited the ER after a serious infection started to spread up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had constructed in a friend’s yard. She was also addicted to fentanyl.
As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and vomited.
Stephanie ultimately gave in. “I need to leave. I have to go home and take a hit.”
She had used fentanyl before seeking medical help and had sufficient opportunity to get treated before she was compelled to leave to get high again. She thought she still had four weeks left to figure out how to get clean and deliver her child.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was severe, but physicians found she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie gave birth to a infant weighing a small weight – premature, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “no.” She was numb. Her pain relief did not work, her final administration of fentanyl had been provided shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Undeserving.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she was unsuccessful. She felt without value, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I required assistance.”
The pervasive expectation that her love for her baby would make her quit only led to increased guilt and negative self-talk, a trigger for her to return to drugs. Yet she could not just wish her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to monitors, so small 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 continued to doubt she wanted to be her mother.
Two days later she decided to give her child the name the same as her nurse, after the attendant who showed compassion to her.
Medical personnel told her about a specialized facility, a unique recovery environment where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is identified with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and medicated while their mothers face parental assessments. But a small, growing network of centers like this facility is showing an important truth: when families are kept intact, results get better, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength to call, but she ultimately reached out. After verifying her eligibility for the program, two staff members came to collect her.
She departed the institution still in recovery, fearful and unsure about what would happen next.
At the care center, Stephanie still feared that child services would come take Izzie – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could walk in and separate them.
For the first two weeks, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about getting by. Drugs came first; faith came last.
Stephanie had a trusted ally, but even that connection was tenuous. The people she loved always found ways to cause pain. She was unable to value herself, not to mention anyone else.
Daily, staff from the facility took her to a treatment center, given as medication. Gradually, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and obvious stomach troubles. She needed feeding therapy. She also had increased sensitivity and required an specialist – all common issues for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I found the strength. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for supervised visits with their babies. An advocate, a mentor, came over with her own five kids in tow to bring treats. 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 wearing casual attire, a gray knit hat with a decoration on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her posture is humble so you do not see her expression. She is holding Izzie up on her leg for the other kids to see and they are gathered around, admiring and touching to the baby.
Jacob, eight, asked the mothers: “Why are there no men?” The moms tried to explain that the men were occupied, engaged elsewhere, that they would be there if they could.
“In the future,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith exchanged glances. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I could do this. I could parent.”
Approaches for managing drug-exposed newborns have been available for years.
The evaluation method was developed in 1975|
