She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
Eight months pregnant and in severe pain, the expectant mother visited the hospital emergency room after an infection began spreading up her legs. Without a job or home, separated from loved ones, she resided in a small structure she had built in a friend’s yard. She was also hooked on fentanyl.
As doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”
She had used fentanyl before arriving at the hospital and had just enough time to get treated before she needed to go home 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 am leaving,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was severe, but doctors had discovered she also had an ruptured membrane. The nurse, her nurse, warned her: if she left, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a medication that eases withdrawal and is commonly used in addiction recovery.
A short time later, on the 12th of November, Stephanie delivered a baby girl weighing just over four pounds – born before term, tiny yet healthy.
When the attendant inquired if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her epidural had failed, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had tried to get clean repeatedly before birth, and felt awful each time she was unsuccessful. She felt without value, berating herself for not being able to overcome the challenge. An obstetrician told her to “only” stop using. Even her source would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her stop using only led to greater shame and self-harm, a cause for her to use again. Yet she could not simply will her addiction away, any more than she could eliminate a long-term illness.
The baby was taken to the special care nursery. When Stephanie eventually visited her, she was hooked up to monitors, so small she thought she would hurt her. Holding her for the first time, she felt detached. “I looked at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to name her baby Izzie, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a innovative treatment home where parents and infants affected by substance use are treated together, not apart.
In numerous states, where a baby is found to have infant withdrawal condition frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a developing system of centers like the care home is demonstrating a key fact: when mothers and babies stay together, recovery succeeds, custody cases decrease and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After verifying her eligibility for the program, a couple of employees came to bring her to the facility.
She stepped out of the hospital still in recovery, scared and uncertain about what would happen next.
At the facility, Stephanie still worried that authorities would come remove her daughter – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could arrive and take her baby away.
For the beginning period, Stephanie remained isolated. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about getting by. Addiction came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to cause pain. She did not know how to care for herself, much less anyone else.
Each day, staff from the center drove her to a treatment center, administered in pill form. Gradually, she was beginning recovery.
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 professional – all common issues for babies exposed to substances.
When a child recognizes these infants need affection, then I was capable. I could parent.
On a day prior to the holiday, Stephanie was in the common room, where parents in active addiction can come for supervised visits with their babies. Katie Bunch-Smith, a mentor, came over with her own family in tow to drop off cookies. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in admiration of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She keeps a photo of the moment. She is clad in black pants and a hoodie, a beanie with a pompom on her head, resting on the floor with the exit nearby. She is lean. Her face is downcast so you cannot see her face. She is presenting her daughter on her leg for the young ones to see and they are standing close, admiring and touching to the baby.
A young boy, eight, asked the moms: “Where are all the dads?” The women attempted to clarify that the fathers had obligations, handling responsibilities, that they would be there if they could.
“In the future,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I could parent.”
Tools for treating infants affected by substances have existed for decades.
The evaluation method was established in 1975|
