She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
Pregnant and experiencing intense discomfort, a woman named Stephanie visited the medical facility 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 assembled in a friend’s yard. She was also hooked on fentanyl.
As medical staff managed 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 take a hit.”
She had used fentanyl before seeking medical help and had sufficient opportunity to get treated before she needed to go home to use once more. She thought she still had four weeks left to find a way to become sober and have this baby.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the leg infection was critical, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would not survive.
She encouraged 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 treatment that reduces symptoms and is frequently utilized in addiction recovery.
Five days later, on 12 November 2022, Stephanie delivered a infant weighing 4lb 8oz – premature, tiny yet healthy.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her last dose of fentanyl had been provided four hours before delivery.
She felt ill. Unprepared to be a mother. Undeserving.
Stephanie had sought recovery several times during pregnancy, and felt horrible each time she failed. She felt worthless, criticizing herself for not being able to do the impossible. An OBGYN told her to “just” 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 bond with her newborn would make her recover only led to increased guilt and negative self-talk, a cause for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate a long-term illness.
The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was connected to monitors, so little she thought she would break her. Cradling her initially, she felt empty. “I gazed upon her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
After two days she decided to call her daughter after her caregiver, after the nurse who had been so kind to her.
Medical personnel told her about a care center, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In numerous states, where a baby is identified with infant withdrawal condition every 18 minutes, infants are still quickly moved to hospitals and medicated while their mothers face parental assessments. But a limited but expanding group of centers like Maddie’s Place is showing an important truth: when families are kept intact, results get better, custody cases decrease and future expenses reduce.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, a couple of employees came to pick her up.
She departed the institution still in withdrawal, anxious and doubtful about what would happen next.
At Maddie’s Place, Stephanie still worried that child services would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could enter and remove her child.
For the beginning period, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about getting by. Substances came first; faith came last.
Stephanie had one close friend, but even that connection was tenuous. The those close to her always found ways to let her down. She lacked the ability to care for herself, not to mention anyone else.
Daily, staff from the center drove her to a recovery program, provided orally. Gradually, she was beginning recovery.
She devoted all her time beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges 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 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 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 guided meetings with their babies. Katie Bunch-Smith, a mentor, stopped by with her own family in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in wonder of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She has an image of the moment. She is wearing black pants and a hoodie, a cap with a pompom on her head, seated on the ground with the entryway at her back. She is slender. Her face is downcast so you cannot see her face. She is holding Izzie up on her lap for the other kids to see and they are standing close, showing interest to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The parents responded that the men were occupied, handling responsibilities, that they would be there given the chance.
“In the future,” 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. “Seeing that even youth understand that newborns require care, then I was able. I would become a mother.”
Tools for treating babies with exposure have been available for years.
The Finnegan NAS scale was developed in 1975|
