Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Transformed Their Futures.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the ER after her infection worsened up her legs. Unemployed and homeless, separated from loved ones, she resided in a small structure she had constructed in a companion's property. She was also addicted to fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Withdrawal was setting in. She bent over the bedside and vomited.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had used fentanyl before seeking medical help and had sufficient opportunity to get treated before she had to return to get high again. She thought she still had several weeks to figure out how to get clean and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but physicians found she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be placed on methadone, a treatment that reduces symptoms and is frequently utilized in substance abuse treatment.
After five days, on a day in November 2022, Stephanie delivered a daughter weighing a small weight – early, small but alive.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her epidural had failed, her last dose of fentanyl had been administered a few hours prior to birth.
She felt sick. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean repeatedly before birth, and felt awful each time she relapsed. She felt hopeless, criticizing herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her dealer would not provide to her when she became obviously with child.
“However, I failed,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her quit only led to deeper self-loathing and negative self-talk, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could will away a chronic disease.
The infant was moved to the NICU. When Stephanie finally saw her her, she was hooked up to medical equipment, so small she thought she would harm her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to call her daughter the same as her nurse, after the nurse who had been so kind to her.
Medical personnel told her about a specialized facility, a innovative treatment home where parents and infants affected by substance use are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a developing system of centers like the care home is showing an important truth: when mothers and babies stay together, results get better, fewer children enter care and long-term costs decline.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, two staff members came to bring her to the facility.
She departed the institution still in detox, scared and uncertain about what would happen next.
At the care center, Stephanie still worried that CPS would come take Izzie – even though she was not sure she wanted to keep her. The anxiety remained: that at any moment, someone could enter and remove her child.
For the initial fortnight, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about enduring. Substances came first; trust came last.
Stephanie had a trusted ally, but even that connection was tenuous. The those close to her always found ways to let her down. She did not know how to value herself, not to mention anyone else.
Each day, staff from Maddie’s Place drove her to a recovery program, given as medication. Slowly, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and severe digestive problems. She needed dietary support. She also had sensory challenges and required an professional – all common issues for babies exposed to substances.
Seeing that even a young person understands the need for care, then I could do this. I would become a mother.
During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for supervised visits with their babies. Katie Bunch-Smith, a mentor, stopped by with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in awe of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She holds a picture of the moment. She is dressed in casual attire, a cap with a decoration on her head, resting on the floor 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 crowding near, showing interest to the baby.
Jacob, eight, asked the mothers: “What about the fathers?” The parents responded that the fathers had obligations, called away to other tasks, that they would be there if they could.
“In the future,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “When a child recognized that infants need affection, then I could do this. I could be a mom.”
Methods to address infants affected by substances have been used for a long time.
The assessment tool was established in 1975|
