She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Transformed Their Futures.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the ER after a serious infection started to spread up her legs. Jobless and without shelter, separated from loved ones, she resided in a small structure she had constructed in a companion's property. She was also addicted to fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and get high.”
She had used fentanyl before seeking medical help and had just enough time to get treated before she needed to go home to relapse. She thought she still had a month remaining to figure out how to get clean and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but physicians found she also had an ruptured membrane. 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 every few hours, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be placed on methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
After five days, on a day in November 2022, Stephanie gave birth to a infant weighing 4lb 8oz – early, small but alive.
When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her pain relief did not work, her final administration of fentanyl had been administered shortly before she gave birth.
She felt ill. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she relapsed. She felt worthless, criticizing herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her source would not provide to her when she became obviously with child.
“Yet I was unable,” she said. “I needed help.”
The pervasive expectation that her affection for her child would make her stop using only led to greater shame and negative self-talk, a trigger for her to use again. Yet she could not simply will her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the special care nursery. When Stephanie at last met her, she was attached to monitors, so tiny she thought she would hurt her. Embracing her at last, she felt empty. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to name her baby the same as her nurse, after the nurse who had been so kind to her.
Nurses and doctors told her about a specialized facility, a unique recovery environment where women and their babies are cared for jointly, not apart.
In much of the US, where a baby is found to have 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 Maddie’s Place is showing an important truth: when mothers and babies stay together, recovery succeeds, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage 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 departed the institution still in withdrawal, scared and uncertain about what would come next.
At the care center, Stephanie still worried that CPS would come remove her daughter – even though she was not sure she wanted to keep her. The fear lingered: that at any moment, someone could arrive 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 lacked confidence at that point.”
Survival outdoors, she said, was about enduring. Drugs came first; faith came last.
Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to cause pain. She was unable to love herself, not to mention anyone else.
Daily, staff from the center transported her to a clinic for methadone, provided orally. Slowly, she was embracing sobriety.
She spent every minute when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed dietary support. She also had sensory challenges and required an professional – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could be a mom.
On a day prior to the holiday, Stephanie remained in the shared space, where individuals struggling with substance use can come for monitored interactions with their babies. Katie Bunch-Smith, a peer support specialist, stopped by with her own family in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in awe of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She keeps a photo of the moment. She is wearing casual attire, a cap with a decoration on her head, resting on the floor with the door behind her. She is lean. Her posture is humble so you miss her features. 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: “What about the fathers?” The parents responded that the dads were busy, called away to other tasks, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and her companion looked at each other. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I could be a mom.”
Approaches for managing drug-exposed newborns have been available for years.
The Finnegan NAS scale was established in 1975|
