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 hospital emergency room after her infection worsened up her legs. Without a job or home, estranged from her family, 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. Symptoms of withdrawal emerged. She leaned over the bed and threw up.
Stephanie ultimately gave in. “I need to leave. I have to go home and get high.”
She had taken the drug before arriving at the hospital and had just enough time 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 have this baby.
The medical professional intervened. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the infection in her legs was serious, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she walked out, she and her baby would not survive.
She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a treatment that reduces symptoms and is commonly used in addiction recovery.
Five days later, on a day in November 2022, Stephanie delivered a daughter weighing a small weight – premature, little but surviving.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been administered shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she relapsed. She felt hopeless, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “just” stop using. Even her supplier declined to supply to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The widespread belief that her affection for her child would make her recover 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 overcome a chronic disease.
The newborn was transferred to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to medical equipment, so tiny she thought she would harm her. Cradling her initially, she felt empty. “I just stared at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to give her child the name Izzie, after the attendant who showed compassion to her.
Hospital staff told her about a care center, a new kind of care center where women and their babies are treated together, not apart.
In numerous states, 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 limited but expanding group of centers like the care home is demonstrating a key fact: when parents and infants remain united, results get better, custody cases decrease and future expenses reduce.
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, a couple of employees came to pick her up.
She departed the institution still in recovery, anxious and doubtful about what would happen next.
At Maddie’s Place, Stephanie still feared that authorities would come seize her child – even though she was hesitant about parenting. The concern persisted: that at any point, someone could arrive and separate them.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about getting by. Addiction came first; faith came last.
Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to hurt her. She did not know how to value herself, let alone anyone else.
Daily, staff from the center transported her to a treatment center, administered in pill form. Over time, she was beginning recovery.
She devoted all her time beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed dietary support. She also had heightened sensory issues and required an occupational therapist – all common issues for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I could do this. I could parent.
On a day prior to the holiday, Stephanie was in the common room, where those still using can come for supervised visits with their babies. A support specialist, a recovery coach, stopped by with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The young ones stared in wonder of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She has an image of the moment. She is dressed in casual attire, a beanie with a decoration on her head, seated on the ground with the exit nearby. She is slender. Her face is downcast so you do not see her expression. She is lifting the baby on her leg for the other kids to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the moms: “Why are there no men?” The moms tried to explain that the dads were busy, called away to other tasks, that they would be there given the chance.
“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 exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I found the courage. I could parent.”
Tools for treating infants affected by substances have been available for years.
The assessment tool was developed in 1975|
