A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
Eight months pregnant and in severe pain, a woman named Stephanie arrived at the hospital emergency room after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she lived in a shed she had built in a acquaintance's garden. 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 ultimately gave in. “Listen, I gotta go. I have to go home and use drugs.”
She had used fentanyl before coming to the ER and had sufficient opportunity to get treated before she needed to go home to relapse. She thought she still had several weeks to plan her recovery and have this baby.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but physicians found she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she departed, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in addiction recovery.
After five days, on 12 November 2022, Stephanie had a baby girl weighing 4lb 8oz – born before term, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her epidural had failed, her previous intake of fentanyl had been provided four hours before delivery.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she failed. She felt worthless, criticizing herself for not being able to achieve the unattainable. An OBGYN told her to “just” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her bond with her newborn would make her stop using only led to greater shame and self-harm, a impetus for her to return to drugs. Yet she could not simply will her addiction away, any more than she could will away a persistent condition.
The baby was taken to the special care nursery. When Stephanie at last met her, she was attached to tubes and leads, so tiny she thought she would break her. Cradling her initially, she felt nothing. “I just stared 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 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 women and their babies are cared for jointly, not apart.
In numerous states, where a baby is identified with infant withdrawal condition every 18 minutes, infants are still rushed to special care and given drugs while their mothers face parental assessments. But a small, growing network of centers like the care home is proving a simple point: when families are kept intact, outcomes improve, custody cases decrease and future expenses reduce.
It took Stephanie some time to build confidence to call, but she finally did. After verifying her eligibility for the program, a couple of employees came to bring her to the facility.
She stepped out of the hospital still in recovery, anxious and doubtful about what would follow.
At Maddie’s Place, Stephanie still worried that child services would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could arrive and remove her child.
For the beginning period, Stephanie remained isolated. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Drugs came first; faith came last.
Stephanie had one close friend, but even that relationship was delicate. The those close to her always found ways to let her down. She did not know how to love herself, much less anyone else.
Each day, staff from Maddie’s Place took her to a recovery program, provided orally. Over time, she was starting to get clean.
She utilized each moment outside treatment 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 specialist – all typical problems for babies exposed to substances.
Seeing that even a young person understands the need for care, then I found the strength. I could be a mom.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a recovery coach, came over with her own five kids in tow to deliver baked goods. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She holds a picture of the moment. She is clad in black pants and a hoodie, a cap with a pompom on her head, sitting on the wooden floor with the exit nearby. She is lean. Her face is downcast so you cannot see her face. She is holding Izzie up on her leg for the children to see and they are crowding near, admiring and touching to the baby.
A young boy, eight, asked the moms: “Where are all the dads?” The parents responded that the men were occupied, called away to other tasks, that they would be there given the chance.
“In the future,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion looked at each other. “I became emotional,” Stephanie said. “When a child recognized that newborns require care, then I was able. I could parent.”
Tools for treating infants affected by substances have existed for decades.
The Finnegan NAS scale was created in 1975|
