She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Transformed Their Futures.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the medical facility after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had built in a companion's property. She was also addicted to fentanyl.
As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She slumped forward and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and get high.”
She had consumed opioids before seeking medical help and had only a brief window to get treated before she was compelled to leave to get high again. She thought she still had a month remaining to plan her recovery and deliver her child.
The nurse had other ideas. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in addiction recovery.
After five days, on 12 November 2022, Stephanie gave birth to a baby girl weighing a small weight – born before term, tiny yet healthy.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was detached. Her pain relief did not work, her last dose of fentanyl had been administered four hours before delivery.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had sought recovery several times during pregnancy, and felt horrible each time she was unsuccessful. She felt worthless, berating herself for not being able to achieve the unattainable. An OBGYN told her to “only” stop using. Even her supplier refused to sell to her when she became visibly pregnant.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her affection for her child would make her recover only led to greater shame and self-abuse, a trigger for her to return to drugs. Yet she could not simply will her addiction away, any more than she could eliminate a persistent condition.
The newborn was transferred to the special care nursery. When Stephanie at last met her, she was connected to medical equipment, so little she thought she would hurt her. Embracing her at last, she felt nothing. “I gazed upon her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to give her child the name Izzie, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a innovative treatment home where women and their babies are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still rushed to special care and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like the care home is showing an important truth: when families are kept intact, recovery succeeds, fewer children enter care and overall savings increase.
It took Stephanie a period to find strength to call, but she finally did. After ensuring she qualified for the program, two staff members came to bring her to the facility.
She stepped out of the hospital still in detox, anxious and doubtful about what would come next.
At the care center, Stephanie still feared that authorities would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any time, someone could walk in and separate them.
For the initial fortnight, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I was suspicious at that point.”
Homelessness, she said, was about enduring. Addiction came first; reliance came last.
Stephanie had a single companion, but even that relationship was delicate. The those close to her always found ways to cause pain. She was unable to care for herself, much less anyone else.
Every day, staff from the center transported her to a recovery program, given as medication. Over time, she was starting to get clean.
She devoted all her time beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and severe digestive problems. She needed nutritional guidance. She also had increased sensitivity and required an professional – all typical problems for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I found the strength. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where parents in active addiction can come for guided meetings with their babies. An advocate, a mentor, visited with her own family in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in admiration of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She has an image of the moment. She is dressed in casual attire, a cap with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her face is downcast so you do not see her expression. She is lifting the baby on her knee for the children to see and they are crowding near, showing interest 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’m going to be the best dad ever. They will know they are valued.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I could parent.”
Methods to address infants affected by substances have been used for a long time.
The Finnegan NAS scale was developed in 1975|
