She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, the expectant mother went to the ER after her infection worsened up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had built in a friend’s yard. She was also hooked on fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and threw up.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had consumed opioids before coming to the ER and had only a brief window to get treated before she had to return to relapse. She thought she still had four weeks left to plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl at regular intervals, 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.
A short time later, on the 12th of November, Stephanie delivered a baby girl weighing 4lb 8oz – premature, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her pain relief did not work, her last dose of fentanyl had been given four hours before delivery.
She felt sick. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she failed. She felt without value, criticizing herself for not being able to achieve the unattainable. An obstetrician told her to “only” stop using. Even her supplier declined to supply to her when she became clearly expecting.
“Yet I was unable,” she said. “I required assistance.”
The widespread belief that her love for her baby would make her stop using only led to deeper self-loathing and self-harm, a impetus for her to use again. Yet she could not simply will her addiction away, any more than she could will away a long-term illness.
The newborn was transferred to the NICU. When Stephanie at last met her, she was hooked up to monitors, so tiny she thought she would harm her. Holding her for the first time, she felt detached. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to name her baby after her caregiver, after the attendant who showed compassion to her.
Hospital staff 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 identified with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still whisked to NICUs and medicated while their mothers face custody evaluations. But a small, growing network of centers like the care home is showing an important truth: when families are kept intact, recovery succeeds, custody cases decrease and overall savings increase.
It took Stephanie some time to build confidence to call, but she eventually made the call. After ensuring she qualified for the program, care providers came to collect her.
She left the medical center still in recovery, scared and uncertain about what would happen next.
At Maddie’s Place, Stephanie still was concerned that child services would come remove her daughter – even though she was uncertain about motherhood. The anxiety remained: that at any moment, someone could enter and remove her child.
For the first two weeks, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Addiction came first; trust came last.
Stephanie had a trusted ally, but even that relationship was delicate. 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 Maddie’s Place took her to a clinic for methadone, provided orally. Slowly, she was starting to get clean.
She spent every minute when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and obvious stomach troubles. She needed feeding therapy. She also had increased sensitivity and required an professional – all common issues for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could be a mom.
On a day prior to the holiday, Stephanie was in the common room, where those still using can come for monitored interactions with their babies. Katie Bunch-Smith, a peer support specialist, visited with her own family in tow to deliver baked goods. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She keeps a photo of the moment. She is clad in casual attire, a gray knit hat with a decoration on her head, sitting on the wooden floor with the door behind her. She is lean. Her posture is humble so you do not see her expression. She is lifting the baby on her knee for the children to see and they are gathered around, fawning and reaching out to the baby.
One child, eight, asked the moms: “What about the fathers?” The moms tried to explain that the fathers had obligations, handling responsibilities, that they would be there if they could.
“When I have kids,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and the specialist looked at each other. “I just lost it and fell apart,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I could do this. I could parent.”
Methods to address infants affected by substances have been available for years.
The evaluation method was established in 1975|