She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Transformed Their Futures.
In her eighth month of pregnancy and suffering, the expectant mother visited the ER after her infection worsened up her legs. Without a job or home, estranged from her family, she stayed in a makeshift shelter she had constructed in a friend’s yard. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. Withdrawal was setting in. She bent over the bedside and threw up.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had consumed opioids before arriving at the hospital and had sufficient opportunity to get treated before she was compelled to leave to use once more. She thought she still had four weeks left to figure out how to get clean and have this baby.
The nurse had other ideas. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was serious, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.
A short time later, on the 12th of November, Stephanie had a baby girl weighing a small weight – born before term, little but surviving.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her anesthesia was ineffective, her last dose of fentanyl had been provided shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt horrible each time she failed. She felt without value, criticizing herself for not being able to achieve the unattainable. An OBGYN told her to “only” stop using. Even her dealer would not provide to her when she became clearly expecting.
“However, I failed,” 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 impetus for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a long-term illness.
The baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to tubes and leads, so tiny she thought she would hurt her. Embracing her at last, she felt nothing. “I gazed upon her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to give her child the name after her caregiver, after the professional who provided support to her.
Hospital staff told her about a care center, 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 infant withdrawal condition regularly, infants are still whisked to NICUs and given drugs while their mothers face child-protection investigations. But a developing system of centers like this facility is proving a simple point: when parents and infants remain united, results get better, custody cases decrease and long-term costs decline.
It took Stephanie some time to build confidence to call, but she eventually made the call. After confirming she would be a good fit for the program, two staff members came to pick her up.
She departed the institution still in detox, scared and uncertain about what would come next.
At the facility, Stephanie still worried that child services would come take Izzie – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could arrive 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 didn’t have a lot of trust at that point.”
Life on the streets, she said, was about getting by. Substances came first; trust came last.
Stephanie had a trusted ally, but even that connection was tenuous. The people she loved always found ways to let her down. She lacked the ability to love herself, much less anyone else.
Each day, staff from the facility drove her to a clinic for methadone, given as medication. Over time, she was beginning recovery.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with intolerance to some formulas and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an occupational therapist – all frequent conditions 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.
On a day prior to the holiday, Stephanie remained in the shared space, where individuals struggling with substance use can come for monitored interactions with their babies. A support specialist, a peer support specialist, visited with her own children in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in awe of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She holds a picture of the moment. She is wearing casual attire, a gray knit hat with a pompom on her head, seated on the ground with the exit nearby. She is slender. Her posture is humble so you miss her features. She is presenting her daughter on her leg for the children to see and they are standing close, admiring and touching to the baby.
A young boy, eight, asked the mothers: “Where are all the dads?” The parents responded that the fathers had obligations, engaged elsewhere, that they would be there given the chance.
“When I have kids,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I could be a mom.”
Tools for treating drug-exposed newborns have been available for years.
The assessment tool was established in 1975|
