A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, a woman named Stephanie arrived at the hospital emergency room after her infection worsened up her legs. Without a job or home, separated from loved ones, she lived in a shed she had constructed in a friend’s yard. She was also hooked on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and threw up.
Stephanie finally broke down. “I have to get out of here. I have to go home and use drugs.”
She had consumed opioids before seeking medical help and had just enough time to get treated before she was compelled to leave to use once more. She thought she still had a month remaining to plan her recovery and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was severe, but doctors had discovered she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be switched to methadone, a medication that eases withdrawal and is frequently utilized in rehabilitation.
After five days, on a day in November 2022, Stephanie gave birth to a daughter weighing a small weight – born before term, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her final administration of fentanyl had been provided shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety several times during pregnancy, and felt horrible each time she relapsed. She felt hopeless, criticizing herself for not being able to do the impossible. An OBGYN told her to “only” stop using. Even her supplier declined to supply to her when she became clearly expecting.
“However, I failed,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her stop using only led to greater shame and self-harm, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The infant was moved to the special care nursery. When Stephanie finally saw her her, she was connected to medical equipment, so small she thought she would harm her. Embracing her at last, she felt detached. “I looked at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to call her daughter after her caregiver, after the professional who provided support to her.
Hospital staff told her about a care center, a new kind of care center where parents and infants affected by substance use are supported as a unit, not apart.
In much of the US, where a baby is identified with infant withdrawal condition frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a limited but expanding group of centers like the care home is showing an important truth: when families are kept intact, outcomes improve, fewer children enter care and long-term costs decline.
It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to pick her up.
She departed the institution still in withdrawal, scared and uncertain about what would follow.
At Maddie’s Place, Stephanie still was concerned that child services would come seize her child – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could walk in and separate them.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Substances came first; reliance came last.
Stephanie had a trusted ally, but even that relationship was delicate. The those close to her always found ways to hurt her. She lacked the ability to love herself, let alone anyone else.
Each day, staff from the center drove her to a treatment center, given as medication. Over time, she was starting to get clean.
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 sensitivity to certain foods and pronounced gastrointestinal issues. She needed dietary support. She also had increased sensitivity and required an professional – all common issues for babies born with NAS.
Seeing that even a young person understands the need for care, then I could do this. I could parent.
During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. A support specialist, a peer support specialist, visited with her own five kids in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in awe of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She keeps a photo of the moment. She is clad in black pants and a hoodie, a beanie with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is lean. Her head is tilted forward so you do not see her expression. She is holding Izzie up on her knee for the children to see and they are crowding near, admiring and touching to the baby.
One child, eight, asked the moms: “Why are there no men?” The parents responded that the dads were busy, called away to other tasks, that they would be there given the chance.
“When I have kids,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and the specialist exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I was able. I could parent.”
Methods to address infants affected by substances have existed for decades.
The evaluation method was established in 1975|
