She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Transformed Their Futures.
Eight months pregnant and in severe pain, a woman named Stephanie arrived at the ER after an infection began spreading up her legs. Without a job or home, estranged from her family, she lived in a shed she had constructed in a companion's property. She was also addicted to fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Withdrawal was setting in. She bent over the bedside and threw up.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and take a hit.”
She had taken the drug before seeking medical help and had sufficient opportunity to get treated before she was compelled to leave to relapse. 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 not allowed to leave.
“I will go,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie gave birth to a baby girl weighing a small weight – premature, tiny yet healthy.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her final administration of fentanyl had been given shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety several times during pregnancy, and felt horrible each time she relapsed. She felt worthless, blaming herself for not being able to achieve the unattainable. An obstetrician told her to “simply” stop using. Even her source would not provide to her when she became clearly expecting.
“Yet I was unable,” she said. “I needed help.”
The pervasive expectation that her love for her baby would make her quit only led to deeper self-loathing and negative self-talk, a trigger for her to return to drugs. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to medical equipment, so little she thought she would harm her. Holding her for the first time, she felt nothing. “I gazed upon 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 give her child the name the same as her nurse, after the professional who provided support to her.
Nurses and doctors told her about a care center, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In many parts of America, where a baby is identified with newborn addiction symptoms regularly, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a small, growing network of centers like the care home is demonstrating a key fact: when mothers and babies stay together, outcomes improve, foster placements fall and long-term costs decline.
It took Stephanie a period to find strength to call, but she eventually made the call. After ensuring she qualified for the program, two staff members came to collect her.
She departed the institution still in detox, anxious and doubtful about what would happen next.
At the facility, Stephanie still was concerned that CPS would come seize her child – even though she was hesitant about parenting. The anxiety remained: that at any moment, someone could arrive and remove her child.
For the first two weeks, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about getting by. Substances came first; reliance came last.
Stephanie had a single companion, but even that connection was tenuous. The people she loved always found ways to let her down. She lacked the ability to value herself, let alone anyone else.
Each day, staff from the center took her to a recovery program, administered in pill form. Slowly, she was starting to get clean.
She utilized each moment outside treatment with Izzie, and could see that her baby was obtaining necessary support 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 heightened sensory issues and required an occupational therapist – all typical problems for babies affected by withdrawal.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for supervised visits with their babies. A support specialist, a recovery coach, visited with her own family in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in wonder of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She keeps a photo of the moment. She is dressed in black pants and a hoodie, a beanie with a pompom on her head, seated on the ground with the door behind her. She is lean. Her posture is humble so you do not see her expression. She is holding Izzie up on her leg for the children to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the mothers: “Where are all the dads?” The moms tried to explain that the fathers had obligations, called away to other tasks, that they would be there if they could.
“In the future,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and Bunch-Smith exchanged glances. “I just lost it and fell apart,” Stephanie said. “When a child recognized that infants need affection, then I could do this. I would become a mother.”
Methods to address babies with exposure have been used for a long time.
The assessment tool was established in 1975|
