A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.

Pregnant and experiencing intense discomfort, the expectant mother arrived at the ER after her infection worsened up her legs. Without a job or home, cut off from her relatives, she stayed in a makeshift shelter she had built in a companion's property. She was also addicted to fentanyl.

As doctors treated her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and became sick.

Stephanie eventually collapsed. “I need to leave. I have to go home and use drugs.”

She had consumed opioids before coming to the ER and had just enough time to get treated before she had to return to use once more. She thought she still had a month remaining to find a way to become sober and have this baby.

The nurse had other ideas. She told Stephanie she was staying put.

“I am leaving,” Stephanie said.

But the hospital refused to discharge her: the leg infection was serious, but doctors had discovered she also had an ruptured membrane. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.

Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in substance abuse treatment.

After five days, on 12 November 2022, Stephanie had a baby girl weighing a small weight – early, tiny yet healthy.

When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “not now.” She was numb. Her epidural had failed, her final administration of fentanyl had been given four hours before delivery.

She felt unwell. Ill-equipped for parenting. Unworthy.

Stephanie had attempted sobriety several times during pregnancy, and felt terrible each time she failed. She felt worthless, blaming herself for not being able to achieve the unattainable. An obstetrician told her to “only” stop using. Even her dealer would not provide to her when she became obviously with child.

“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 greater shame and self-abuse, a impetus for her to return to drugs. Yet she could not just wish her addiction away, any more than she could eliminate a long-term illness.

The infant was moved to the NICU. When Stephanie at last met her, she was attached to medical equipment, so little she thought she would break her. Cradling her initially, she felt empty. “I gazed upon her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.

After two days she decided to name her baby after her caregiver, after the attendant who showed compassion to her.

Medical personnel told her about a specialized facility, a unique recovery environment 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 neonatal abstinence syndrome (NAS) regularly, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face custody evaluations. But a limited but expanding group of centers like the care home is proving a simple point: when mothers and babies stay together, outcomes improve, fewer children enter care and overall savings increase.

It took Stephanie some time to build confidence to call, but she finally did. After ensuring she qualified for the program, a couple of employees came to pick her up.

She stepped out of the hospital still in detox, anxious and doubtful about what would happen next.

At the care center, Stephanie still worried that child services would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any point, someone could enter and take her baby away.

For the initial fortnight, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”

Life on the streets, she said, was about survival. Addiction came first; trust came last.

Stephanie had a trusted ally, but even that relationship was delicate. The individuals she cared for always found ways to hurt her. She was unable to love herself, much less anyone else.

Every day, staff from Maddie’s Place took her to a treatment center, provided orally. Slowly, she was beginning recovery.

She spent every minute beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed nutritional guidance. She also had sensory challenges and required an professional – all common issues for babies affected by withdrawal.

Seeing that even a young person understands the need for care, then I was capable. I would become a mother.

During a pre-holiday visit, Stephanie was in the common room, where parents in active addiction can come for monitored interactions with their babies. Katie Bunch-Smith, a mentor, visited with her own family in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.

The kids looked amazed in awe of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”

She has an image of the moment. She is wearing black pants and a hoodie, a beanie with a bobble on her head, resting on the floor with the door behind her. She is lean. Her face is downcast so you do not see her expression. She is holding Izzie up on her knee for the children to see and they are gathered around, admiring and touching to the baby.

A young boy, eight, asked the moms: “What about the fathers?” The women attempted to clarify that the fathers had obligations, handling responsibilities, that they would be there if they could.

“In the future,” Jacob said, “I plan to be a great parent. I will teach them about love.”

Stephanie and the specialist made eye contact. “I became emotional,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I would become a mother.”

Methods to address babies with exposure have been used for a long time.

The Finnegan NAS scale was established in 1975|