She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother went to the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, cut off from her relatives, she lived in a shed she had assembled in a friend’s yard. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. Symptoms of withdrawal emerged. She leaned over the bed and threw up.
Stephanie eventually collapsed. “I need to leave. I have to go home and take a hit.”
She had used fentanyl before arriving at the hospital and had sufficient opportunity to get treated before she had to return to get high again. She thought she still had several weeks to plan her recovery and deliver her child.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie controlled doses 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 treatment that reduces symptoms and is commonly used in substance abuse treatment.
A short time later, on 12 November 2022, Stephanie delivered a baby girl weighing just over four pounds – early, tiny yet healthy.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been administered four hours before delivery.
She felt sick. Ill-equipped for parenting. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she relapsed. She felt hopeless, berating herself for not being able to achieve the unattainable. An doctor told her to “only” stop using. Even her supplier refused to sell to her when she became visibly pregnant.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her affection for her child would make her recover only led to greater shame and negative self-talk, a trigger for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a persistent condition.
The baby was taken to the NICU. When Stephanie eventually visited her, she was attached to medical equipment, so tiny she thought she would harm her. Embracing her at last, she felt empty. “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.
After two days she decided to call her daughter Izzie, after the professional who provided support to her.
Medical personnel told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are cared for jointly, not apart.
In many parts of America, where a baby is identified with newborn addiction symptoms regularly, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a small, growing network of centers like this facility is proving a simple point: when families are kept intact, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility for the program, two staff members came to bring her to the facility.
She left the medical center still in recovery, fearful and unsure about what would follow.
At the facility, Stephanie still feared that child services would come remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any time, someone could enter and take her baby away.
For the initial fortnight, Stephanie remained isolated. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about survival. Addiction came first; faith came last.
Stephanie had a trusted ally, but even that relationship was delicate. The individuals she cared for always found ways to cause pain. She was unable to love herself, let alone anyone else.
Each day, staff from the facility took her to a clinic for methadone, provided orally. Gradually, she was beginning recovery.
She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an professional – all common issues for babies exposed to substances.
Seeing that even a young person understands the need for care, then I found the strength. I could parent.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a mentor, came over with her own children in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a pompom on her head, seated on the ground with the door behind her. She is thin. Her posture is humble so you cannot see her face. She is lifting the baby on her knee for the young ones to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the parents: “Where are all the dads?” The women attempted to clarify that the men were occupied, engaged elsewhere, that they would be there if possible.
“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and Bunch-Smith exchanged glances. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I was able. I would become a mother.”
Methods to address drug-exposed newborns have existed for decades.
The Finnegan NAS scale was established in 1975|
