A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Transformed Their Futures.
Eight months pregnant and in severe pain, a woman named Stephanie visited the medical facility after her infection worsened up her legs. Unemployed and homeless, cut off from her relatives, she resided in a small structure she had built in a acquaintance's garden. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. 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 seeking medical help and had only a brief window to get treated before she needed to go home to use once more. She thought she still had a month remaining to find a way to become sober and give birth.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the infection in her legs was critical, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that symptoms could threaten 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 rehabilitation.
After five days, on 12 November 2022, Stephanie gave birth to a infant weighing 4lb 8oz – early, tiny yet healthy.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her pain relief did not work, her final administration of fentanyl had been provided four hours before delivery.
She felt sick. Not ready for motherhood. Unworthy.
Stephanie had attempted sobriety several times during pregnancy, and felt terrible each time she failed. She felt hopeless, criticizing herself for not being able to achieve the unattainable. An doctor told her to “just” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I needed help.”
The pervasive expectation that her love for her baby would make her recover only led to greater shame and self-abuse, a cause for her to return to drugs. Yet she could not just wish her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie at last met her, she was hooked up to medical equipment, so small she thought she would break her. Embracing her at last, she felt empty. “I gazed upon her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Two days later she decided to name her baby after her caregiver, after the nurse who had been so kind to her.
Medical personnel told her about a specialized facility, a innovative treatment home where women and their babies are treated together, not apart.
In many parts of America, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still whisked to NICUs and medicated while their mothers face custody evaluations. But a small, growing network of centers like the care home is proving a simple point: when families are kept intact, outcomes improve, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she finally did. After verifying her eligibility for the program, a couple of employees came to collect her.
She left the medical center still in recovery, anxious and doubtful about what would come next.
At the care center, 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 first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about enduring. Substances came first; reliance came last.
Stephanie had a trusted ally, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She did not know how to care for herself, much less anyone else.
Every day, staff from the facility took her to a clinic for methadone, administered in pill form. Slowly, she was starting to get clean.
She devoted all her time when not in sessions 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 severe digestive problems. She needed feeding therapy. She also had sensory challenges and required an professional – all frequent conditions for babies exposed to substances.
When a child recognizes these infants need affection, then I could do this. I could parent.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for monitored interactions with their babies. Katie Bunch-Smith, a mentor, came over with her own five kids in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in admiration of the small baby 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 clad in black pants and a hoodie, a gray knit hat with a bobble on her head, sitting on the wooden floor with the door behind her. She is slender. Her face is downcast so you do not see her expression. She is presenting her daughter on her lap for the young ones to see and they are gathered around, showing interest to the baby.
A young boy, eight, asked the parents: “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 plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion 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 would become a mother.”
Methods to address babies with exposure have been available for years.
The assessment tool was established in 1975|
