A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, a woman named Stephanie went to the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had constructed in a acquaintance's garden. She was also hooked on fentanyl.
As doctors treated her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie eventually collapsed. “I need to leave. I have to go home and take a hit.”
She had consumed opioids before seeking medical help and had just enough time to get treated before she needed to go home to relapse. She thought she still had a month remaining to figure out how to get clean and deliver her child.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the leg infection was critical, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
After five days, on the 12th of November, Stephanie had a baby girl weighing a small weight – premature, little but surviving.
When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was numb. Her epidural had failed, her final administration of fentanyl had been provided four hours before delivery.
She felt sick. Ill-equipped for parenting. Unworthy.
Stephanie had tried to get clean repeatedly before birth, and felt horrible each time she was unsuccessful. She felt without value, blaming herself for not being able to do the impossible. An doctor told her to “only” stop using. Even her source refused to sell to her when she became clearly expecting.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her affection for her child would make her recover only led to increased guilt and self-abuse, a cause for her to return to drugs. Yet she could not just wish her addiction away, any more than she could will away a long-term illness.
The infant was moved to the NICU. When Stephanie eventually visited her, she was connected to medical equipment, so tiny she thought she would break her. Cradling her initially, she felt empty. “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.
Following a brief period 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 specialized facility, a new kind of care center where women and their babies are supported as a unit, not apart.
In many parts of America, where a baby is identified with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and medicated while their mothers face custody evaluations. But a developing system of centers like this facility is showing an important truth: when families are kept intact, results get better, custody cases decrease and overall savings increase.
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, care providers came to pick her up.
She departed the institution still in detox, anxious and doubtful about what would come next.
At the facility, Stephanie still worried that CPS would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any time, someone could walk in and take her baby away.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about survival. Drugs came first; reliance came last.
Stephanie had a trusted ally, but even that connection was tenuous. The individuals she cared for always found ways to let her down. She was unable to value herself, much less anyone else.
Each day, staff from the facility transported her to a recovery program, provided orally. Slowly, she was embracing sobriety.
She spent every minute outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an specialist – all common issues for babies born with NAS.
When a child recognizes these infants need affection, then I was capable. I could be a mom.
During a pre-holiday visit, Stephanie remained in the shared space, where those still using can come for monitored interactions with their babies. A support specialist, a mentor, came over with her own children in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in awe of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, seated on the ground with the door behind her. She is thin. Her head is tilted forward so you cannot see her face. She is lifting the baby on her leg 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 women attempted to clarify that the dads were busy, called away to other tasks, that they would be there if they could.
“Once I become a parent,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that infants need affection, then I could do this. I could parent.”
Approaches for managing babies with exposure have existed for decades.
The assessment tool was established in 1975|