She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother visited the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had assembled in a companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Withdrawal was setting in. She bent over the bedside and became sick.
Stephanie finally broke down. “I have to get out of here. I have to go home and get high.”
She had taken the drug before arriving at the hospital and had sufficient opportunity to get treated before she had to return to use once more. She thought she still had several weeks to find a way to become sober and deliver her child.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the leg infection was critical, but doctors had discovered she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be transitioned to methadone, a drug that alleviates cravings and is commonly used in rehabilitation.
Five days later, on 12 November 2022, Stephanie had a baby girl weighing a small weight – premature, little but surviving.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her epidural had failed, her previous intake of fentanyl had been given shortly before she gave birth.
She felt unwell. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she relapsed. She felt worthless, blaming herself for not being able to do the impossible. An doctor told her to “simply” stop using. Even her source refused to sell to her when she became clearly expecting.
“But I couldn’t,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her quit only led to increased guilt and negative self-talk, a impetus for her to use again. Yet she could not simply will her addiction away, any more than she could overcome a chronic disease.
The infant was moved to the NICU. When Stephanie eventually visited her, she was hooked up to tubes and leads, so tiny she thought she would hurt her. Cradling her initially, she felt empty. “I looked at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to call her daughter Izzie, after the professional who provided support to her.
Nurses and doctors told her about a care center, a innovative treatment home where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face parental assessments. But a limited but expanding group of centers like the care home is demonstrating a key fact: when families are kept intact, outcomes improve, foster placements fall and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, a couple of employees came to collect her.
She left the medical center still in recovery, scared and uncertain about what would happen next.
At the facility, Stephanie still was concerned that child services would come remove her daughter – even though she was hesitant about parenting. The concern persisted: that at any moment, someone could arrive and remove her child.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about enduring. Addiction came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to let her down. She lacked the ability to value herself, let alone anyone else.
Every day, staff from the center drove her to a treatment center, administered in pill form. Slowly, she was starting to get clean.
She spent every minute when not in sessions 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 pronounced gastrointestinal issues. She needed dietary support. She also had sensory challenges and required an occupational therapist – all common issues for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I was capable. I could be a mom.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. A support specialist, a mentor, stopped by with her own family in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in wonder of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She holds a picture of the moment. She is wearing black pants and a hoodie, a gray knit hat with a bobble on her head, resting on the floor with the entryway at her back. She is thin. Her head is tilted forward so you do not see her expression. She is lifting the baby on her lap for the children to see and they are gathered around, fawning and reaching out to the baby.
One child, eight, asked the moms: “Why are there no men?” The women attempted to clarify that the dads were busy, called away to other tasks, 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. “When a child recognized that these babies deserve to be loved, then I found the courage. I could be a mom.”
Methods to address infants affected by substances have existed for decades.
The assessment tool was established in 1975|
