She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
Pregnant and experiencing intense discomfort, a woman named Stephanie visited the ER after a serious infection started to spread up her legs. Unemployed and homeless, cut off from her relatives, she resided in a small structure she had built in a companion's property. She was also hooked on fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She slumped forward and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
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 four weeks left to figure out how to get clean and give birth.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the leg infection was severe, but physicians found she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she departed, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that abstinence might harm her and the baby. After delivery Stephanie would be transitioned to methadone, a drug that alleviates cravings and is commonly used in addiction recovery.
After five days, on the 12th of November, Stephanie gave birth to a daughter weighing 4lb 8oz – premature, tiny yet healthy.
When the nurse asked if she wanted to embrace her child, Stephanie said “no.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been given a few hours prior to birth.
She felt sick. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety several times during pregnancy, and felt horrible each time she was unsuccessful. She felt worthless, berating herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her supplier would not provide to her when she became obviously with child.
“However, I failed,” she said. “I required assistance.”
The pervasive expectation that her love for her baby would make her stop using only led to deeper self-loathing and self-harm, a impetus for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was connected to medical equipment, so tiny she thought she would harm her. Holding her for the first time, she felt empty. “I looked at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to call her daughter after her caregiver, after the attendant who showed compassion to her.
Medical personnel told her about a specialized facility, a unique recovery environment where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs and medicated while their mothers face custody evaluations. But a developing system of centers like this facility is showing an important truth: when mothers and babies stay together, outcomes improve, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to bring her to the facility.
She departed the institution still in withdrawal, fearful and unsure about what would happen next.
At the facility, Stephanie still worried that CPS would come remove her daughter – even though she was uncertain about motherhood. The fear lingered: that at any point, someone could enter and separate them.
For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about getting by. Addiction came first; trust came last.
Stephanie had a trusted ally, but even that connection was tenuous. The those close to her always found ways to hurt her. She did not know how to care for herself, much less anyone else.
Daily, staff from Maddie’s Place transported her to a recovery program, administered in pill form. Slowly, she was embracing sobriety.
She spent every minute outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed dietary support. She also had heightened sensory issues and required an specialist – all common issues for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for guided meetings with their babies. Katie Bunch-Smith, a recovery coach, stopped by with her own five kids in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in admiration of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She holds a picture of the moment. She is wearing black pants and a hoodie, a beanie with a decoration on her head, seated on the ground with the exit nearby. She is lean. Her head is tilted forward so you cannot see her face. She is holding Izzie up on her lap for the other kids to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the parents: “What about the fathers?” The moms tried to explain that the dads were busy, called away to other tasks, that they would be there if possible.
“In the future,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and her companion looked at each other. “I became emotional,” Stephanie said. “If this little kid could see that newborns require care, then I was able. I would become a mother.”
Tools for treating babies with exposure have existed for decades.
The Finnegan NAS scale was established in 1975|
