She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
Eight months pregnant and in severe pain, the expectant mother visited the ER after her infection worsened up her legs. Without a job or home, separated from loved ones, she lived in a shed she had built in a acquaintance's garden. She was also dependent on fentanyl.
As medical staff managed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She leaned over the bed and threw up.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and take a hit.”
She had taken the drug 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 several weeks to figure out how to get clean and have this baby.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the infection in her legs was severe, but doctors had discovered she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a treatment that reduces symptoms and is often prescribed in rehabilitation.
Five days later, on 12 November 2022, Stephanie had a baby girl weighing a small weight – early, small but alive.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her final administration of fentanyl had been given shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she failed. She felt worthless, criticizing herself for not being able to do the impossible. An obstetrician told her to “just” stop using. Even her dealer would not provide to her when she became visibly pregnant.
“Yet I was unable,” she said. “I had to seek support.”
The common assumption that her love for her baby would make her recover only led to increased guilt and negative self-talk, a trigger for her to return to drugs. Yet she could not easily command her addiction away, any more than she could overcome a persistent condition.
The infant was moved to the special care nursery. When Stephanie at last met her, she was connected to medical equipment, so little she thought she would break her. Embracing her at last, she felt nothing. “I gazed upon 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 name her baby Izzie, after the professional who provided support to her.
Nurses and doctors told her about a specialized facility, a unique recovery environment where women and their babies are cared for jointly, not apart.
In much of the US, where a baby is identified with infant withdrawal condition regularly, infants are still quickly moved to hospitals and given drugs while their mothers face child-protection investigations. But a developing system of centers like the care home is proving a simple point: when families are kept intact, recovery succeeds, fewer children enter care and long-term costs decline.
It took Stephanie some time to build confidence to call, but she finally did. After ensuring she qualified for the program, care providers came to pick her up.
She departed the institution still in withdrawal, fearful and unsure about what would happen next.
At the facility, Stephanie still was concerned that CPS would come remove her daughter – even though she was uncertain about motherhood. The anxiety remained: that at any point, someone could enter and separate them.
For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Substances came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The people she loved always found ways to let her down. She was unable to love herself, let alone anyone else.
Daily, staff from Maddie’s Place transported her to a recovery program, administered in pill form. Over time, she was starting to get clean.
She spent every minute beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an professional – all typical problems for babies affected by withdrawal.
When a child recognizes these infants need affection, then I was capable. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a recovery coach, visited with her own five kids in tow to bring treats. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She has an image of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a pompom on her head, resting on the floor with the entryway at her back. She is lean. Her head is tilted forward so you cannot see her face. She is holding Izzie up on her leg for the young ones to see and they are crowding near, admiring and touching to the baby.
One child, eight, asked the moms: “What about the fathers?” The women attempted to clarify that the dads were busy, called away to other tasks, that they would be there if they could.
“When I have kids,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and her companion looked at each other. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I found the courage. I would become a mother.”
Methods to address babies with exposure have been available for years.
The Finnegan NAS scale was established in 1975|
