She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother went to the ER after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had assembled in a companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and became sick.
Stephanie ultimately gave in. “I need to leave. I have to go home and take a hit.”
She had used fentanyl before coming to the ER and had only a brief window to get treated before she had to return to get high again. She thought she still had four weeks left to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was serious, but medical staff detected she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she left, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a medication that eases withdrawal and is often prescribed in substance abuse treatment.
A short time later, on the 12th of November, Stephanie delivered a daughter weighing 4lb 8oz – premature, tiny yet healthy.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was numb. Her epidural had failed, her last dose of fentanyl had been given shortly before she gave birth.
She felt ill. Not ready for motherhood. Undeserving.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she relapsed. She felt hopeless, criticizing herself for not being able to overcome the challenge. An doctor told her to “only” stop using. Even her source would not provide to her when she became obviously with child.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her love for her baby would make her recover only led to increased guilt and self-harm, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could overcome a persistent condition.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was connected to tubes and leads, so tiny she thought she would break her. Embracing her at last, she felt nothing. “I just stared at her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to call her daughter Izzie, after the nurse who had been so kind to her.
Hospital staff told her about a care center, a innovative treatment home where parents and infants affected by substance use are cared for jointly, not apart.
In numerous states, where a baby is identified with newborn addiction symptoms regularly, 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 parents and infants remain united, results get better, custody cases decrease 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, care providers came to pick her up.
She stepped out of the hospital still in recovery, scared and uncertain about what would happen next.
At Maddie’s Place, Stephanie still worried that CPS would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could walk in and take her baby away.
For the beginning period, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about survival. Drugs came first; trust came last.
Stephanie had a trusted ally, but even that relationship was delicate. The those close to her always found ways to let her down. She was unable to care for herself, much less anyone else.
Every day, staff from the center drove her to a treatment center, provided orally. Gradually, she was starting to get clean.
She spent every minute 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 sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had increased sensitivity and required an occupational therapist – all typical problems for babies born with NAS.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
On a day prior to the holiday, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a recovery coach, came over 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 small baby in Stephanie’s arms. “They showed no judgment,” 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 dark trousers and a sweatshirt, a gray knit hat with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is lean. Her face is downcast so you miss her features. She is holding Izzie up on her knee for the other kids to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the moms: “Why are there no men?” The parents responded that the dads were busy, called away to other tasks, that they would be there if they could.
“When I have kids,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith looked at each other. “I just lost it and fell apart,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I could parent.”
Tools for treating babies with exposure have been available for years.
The Finnegan NAS scale was created in 1975|
