A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the hospital emergency room after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had assembled in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Withdrawal was setting in. She bent over the bedside and vomited.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and use drugs.”
She had taken the drug before coming to the ER and had just enough time to get treated before she was compelled to leave to relapse. 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 not allowed to leave.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the leg infection was critical, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she walked out, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be switched to methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
Five days later, on a day in November 2022, Stephanie had a daughter weighing just over four pounds – early, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was detached. Her anesthesia was ineffective, her last dose of fentanyl had been given a few hours prior to birth.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had sought recovery several times during pregnancy, and felt horrible each time she was unsuccessful. She felt hopeless, blaming herself for not being able to achieve the unattainable. An OBGYN told her to “simply” stop using. Even her supplier declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I required assistance.”
The widespread belief that her affection for her child would make her stop using only led to greater shame and negative self-talk, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could will away a long-term illness.
The newborn was transferred to the neonatal intensive care unit. When Stephanie at last met her, she was attached to monitors, so little she thought she would break her. Holding her for the first time, she felt detached. “I just stared at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to give her child the name after her caregiver, after the professional who provided support to her.
Nurses and doctors told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In much of the US, where a baby is found to have neonatal abstinence syndrome (NAS) regularly, infants are still quickly moved to hospitals and medicated while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when mothers and babies stay together, results get better, custody cases decrease and long-term costs decline.
It took Stephanie some time to build confidence to call, but she eventually made the call. After confirming she would be a good fit for the program, a couple of employees came to bring her to the facility.
She left the medical center still in detox, anxious and doubtful about what would follow.
At the care center, Stephanie still feared that child services would come remove her daughter – even though she was not sure she wanted to keep her. The anxiety remained: that at any point, someone could walk in and take her baby away.
For the beginning period, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about survival. Substances came first; faith came last.
Stephanie had one close friend, but even that connection was tenuous. The individuals she cared for always found ways to let her down. She was unable to care for herself, much less anyone else.
Daily, staff from the center took her to a recovery program, administered in pill form. Gradually, she was beginning recovery.
She utilized each moment 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 sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had heightened sensory issues and required an professional – all common issues for babies born with NAS.
When a child recognizes these infants need affection, then I found the strength. I could be a mom.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a mentor, visited with her own children in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She keeps a photo of the moment. She is clad in black pants and a hoodie, a gray knit hat with a decoration on her head, seated on the ground with the exit nearby. She is thin. Her head is tilted forward so you miss her features. She is lifting the baby 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 mothers: “Where are all the dads?” The women attempted to clarify that the fathers had obligations, handling responsibilities, that they would be there given the chance.
“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 made eye contact. “I became emotional,” Stephanie said. “Seeing that even youth understand that newborns require care, then I was able. I could be a mom.”
Tools for treating babies with exposure have been used for a long time.
The assessment tool was developed in 1975|
