A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie visited the hospital emergency room after an infection began spreading up her legs. Unemployed and homeless, cut off from her relatives, she lived in a shed she had assembled in a friend’s yard. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She slumped forward and vomited.
Stephanie finally broke down. “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 was compelled to leave to use once more. She thought she still had a month remaining 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 hospital refused to discharge her: the leg infection was severe, but physicians found she also had an leakage of amniotic fluid. The nurse, 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 periodically, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is often prescribed in addiction recovery.
Five days later, on 12 November 2022, Stephanie had a infant weighing just over four pounds – early, small but alive.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been provided a few hours prior to birth.
She felt sick. Not ready for motherhood. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt awful each time she was unsuccessful. She felt worthless, blaming herself for not being able to achieve the unattainable. An doctor told her to “just” stop using. Even her supplier refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The pervasive expectation that her bond with her newborn would make her recover only led to increased guilt and self-abuse, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could will away a persistent condition.
The baby was taken to the special care nursery. When Stephanie eventually visited her, she was attached to tubes and leads, so tiny she thought she would break her. Embracing her at last, she felt nothing. “I just stared at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Two days later she decided to give her child the name after her caregiver, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a unique recovery environment where women and their babies are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition frequently, infants are still rushed to special care and treated with pharmaceuticals while their mothers face parental assessments. But a developing system of centers like this facility is showing an important truth: when families are kept intact, recovery succeeds, custody cases decrease and future expenses reduce.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After confirming she would be a good fit for the program, care providers came to collect her.
She departed the institution still in recovery, fearful and unsure about what would come next.
At the facility, Stephanie still feared that authorities would come remove her daughter – even though she was not sure she wanted to keep her. The concern persisted: that at any moment, someone could walk in and separate them.
For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Drugs came first; faith came last.
Stephanie had one close friend, but even that connection was tenuous. The those close to her always found ways to let her down. She lacked the ability to value herself, much less anyone else.
Each day, staff from the center transported her to a treatment center, administered in pill form. Gradually, she was beginning recovery.
She utilized each moment when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an professional – all common issues for babies affected by withdrawal.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for monitored interactions with their babies. An advocate, a peer support specialist, visited with her own five kids in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in awe of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is wearing dark trousers and a sweatshirt, a beanie with a decoration on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her face is downcast so you miss her features. She is lifting the baby on her leg for the other kids to see and they are standing close, showing interest to the baby.
One child, eight, asked the mothers: “Where are all the dads?” The parents responded that the men were occupied, handling responsibilities, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and the specialist made eye contact. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I could do this. I could be a mom.”
Methods to address drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was developed in 1975|
