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 went to the ER after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she stayed in a makeshift shelter she had assembled in a acquaintance's garden. She was also addicted to fentanyl.
As medical staff managed her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and vomited.
Stephanie ultimately gave in. “I need to leave. I have to go home and use drugs.”
She had consumed opioids 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 find a way to become sober 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 critical, but medical staff detected she also had an ruptured membrane. The nurse, her nurse, warned her: if she left, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.
A short time later, on a day in November 2022, Stephanie delivered a infant weighing just over four pounds – premature, tiny yet healthy.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been administered four hours before delivery.
She felt ill. Ill-equipped for parenting. Unworthy.
Stephanie had sought recovery repeatedly before birth, and felt awful each time she was unsuccessful. She felt hopeless, criticizing 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 obviously with child.
“However, I failed,” she said. “I had to seek support.”
The common assumption that her love for her baby would make her quit only led to deeper self-loathing and self-abuse, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could eliminate a long-term illness.
The infant was moved to the special care nursery. When Stephanie at last met her, she was connected to tubes and leads, so little she thought she would break her. Holding her for the first time, she felt nothing. “I looked at her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the professional who provided support to her.
Nurses and doctors told her about a care center, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In many parts of America, where a baby is identified with newborn addiction symptoms regularly, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is demonstrating a key fact: when families are kept intact, recovery succeeds, fewer children enter care and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, two staff members came to bring her to the facility.
She stepped out of the hospital still in withdrawal, scared and uncertain about what would come next.
At the facility, Stephanie still feared that CPS would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any point, someone could arrive and take her baby away.
For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about enduring. Addiction came first; trust came last.
Stephanie had one close friend, but even that connection was tenuous. The individuals she cared for always found ways to cause pain. She lacked the ability to love herself, not to mention anyone else.
Each day, staff from Maddie’s Place transported her to a treatment center, given as medication. Slowly, she was beginning recovery.
She devoted all her time outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed nutritional guidance. She also had increased sensitivity and required an professional – all common issues for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I found the strength. I could parent.
On a day prior to the holiday, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. An advocate, a recovery coach, came over with her own family in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in wonder of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She keeps a photo of the moment. She is clad in casual attire, a gray knit hat with a bobble on her head, seated on the ground with the door behind her. She is slender. Her posture is humble so you miss her features. She is holding Izzie up on her knee for the children to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The women attempted to clarify that the men were occupied, called away to other tasks, that they would be there if possible.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I just lost it and fell apart,” 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 evaluation method was established in 1975|
