She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Transformed Their Futures.
Pregnant and experiencing intense discomfort, the expectant mother went to the medical facility after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she resided in a small structure she had assembled in a companion's property. She was also hooked on fentanyl.
As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and became sick.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and get high.”
She had consumed opioids before coming to the ER and had sufficient opportunity to get treated before she had to return to use once more. She thought she still had a month remaining to plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would be at risk of death.
The nurse convinced 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 medication that eases withdrawal and is often prescribed in substance abuse treatment.
After five days, on the 12th of November, Stephanie had a baby girl weighing 4lb 8oz – born before term, small but alive.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “not now.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been given shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she failed. She felt hopeless, criticizing herself for not being able to overcome the challenge. An doctor 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 required assistance.”
The pervasive expectation that her love for her baby would make her quit only led to increased guilt and self-abuse, 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 long-term illness.
The baby was taken to the special care nursery. When Stephanie at last met her, she was attached to medical equipment, so tiny she thought she would break her. Embracing her at last, she felt detached. “I looked at her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to call her daughter after her caregiver, after the nurse who had been so kind to her.
Nurses and doctors 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 many parts of America, where a baby is identified with infant withdrawal condition regularly, infants are still rushed to special care and treated with pharmaceuticals while their mothers face custody evaluations. But a limited but expanding group of centers like the care home is showing an important truth: when mothers and babies stay together, outcomes improve, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After verifying her eligibility for the program, a couple of employees came to collect her.
She stepped out of the hospital still in recovery, fearful and unsure about what would follow.
At Maddie’s Place, Stephanie still worried that CPS would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any point, someone could walk in and take her baby away.
For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about survival. Addiction came first; trust came last.
Stephanie had a single companion, but even that connection was tenuous. The those close to her always found ways to let her down. She did not know how to care for herself, let alone anyone else.
Each day, staff from the center took her to a treatment center, provided orally. Slowly, she was starting to get clean.
She devoted all her time beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with intolerance to some formulas and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an occupational therapist – all common issues for babies born with NAS.
Seeing that even a young person understands the need for care, then I found the strength. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where parents in active addiction can come for supervised visits with their babies. Katie Bunch-Smith, a recovery coach, came over with her own family in tow to deliver baked goods. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in awe of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She keeps a photo of the moment. She is wearing casual attire, a gray knit hat with a decoration on her head, resting on the floor with the door behind her. She is lean. Her face is downcast so you miss her features. She is lifting the baby on her leg for the other kids to see and they are gathered around, admiring and touching to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The parents responded that the dads were busy, handling responsibilities, that they would be there if possible.
“Once I become a parent,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith looked at each other. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I could do this. I could parent.”
Methods to address infants affected by substances have been available for years.
The evaluation method was developed in 1975|
