A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother went to the ER after her infection worsened up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had constructed in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and take a hit.”
She had taken the drug before arriving at the hospital 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 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 infection in her legs was critical, but doctors had discovered she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.
Five days later, on a day in November 2022, Stephanie gave birth to a daughter weighing just over four pounds – born before term, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her epidural had failed, her last dose of fentanyl had been administered four hours before delivery.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had attempted sobriety several times during pregnancy, and felt horrible each time she was unsuccessful. She felt worthless, berating herself for not being able to achieve the unattainable. An OBGYN told her to “only” stop using. Even her dealer would not provide to her when she became obviously with child.
“Yet I was unable,” she said. “I had to seek support.”
The common assumption that her affection for her child would make her recover only led to increased guilt and self-harm, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The infant was moved to the NICU. When Stephanie at last met her, she was attached to medical equipment, so little she thought she would break her. Holding her for the first time, 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 give her child the name the same as her nurse, after the professional who provided support to her.
Hospital staff told her about a specialized facility, a unique recovery environment where mothers and their drug-exposed newborns are cared for jointly, not apart.
In many parts of America, where a baby is identified with neonatal abstinence syndrome (NAS) frequently, infants are still rushed to special care and medicated while their mothers face parental assessments. But a limited but expanding group of centers like this facility is proving a simple point: when mothers and babies stay together, results get better, foster placements fall and overall savings increase.
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 pick her up.
She departed the institution still in detox, scared and uncertain about what would happen next.
At the care center, Stephanie still feared that child services would come seize her child – even though she was hesitant about parenting. The concern persisted: that at any time, someone could enter and remove her child.
For the beginning period, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Substances came first; faith came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She did not know how to care for herself, let alone anyone else.
Every day, staff from the facility took her to a recovery program, administered in pill form. Over time, she was embracing sobriety.
She devoted all her time beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and severe digestive problems. She needed nutritional guidance. She also had heightened sensory issues and required an occupational therapist – all frequent conditions for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I found the strength. I would become a mother.
On a day prior to the holiday, Stephanie was in the common room, where those still using can come for guided meetings with their babies. An advocate, a recovery coach, visited with her own family in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She holds a picture of the moment. She is wearing black pants and a hoodie, a cap with a bobble on her head, sitting on the wooden floor with the exit nearby. She is lean. Her head is tilted forward so you do not see her expression. She is holding Izzie up on her knee for the other kids to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the mothers: “Why are there no men?” The women attempted to clarify that the fathers had obligations, called away to other tasks, that they would be there if possible.
“When I have kids,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and Bunch-Smith exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I found the courage. I would become a mother.”
Approaches for managing babies with exposure have been available for years.
The assessment tool was established in 1975|
