She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie visited the medical facility after her infection worsened up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had built in a acquaintance's garden. She was also addicted to fentanyl.
As medical staff managed her infection, she started to feel anxious. 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 arriving at the hospital and had only a brief window to get treated before she needed to go home to use once more. She thought she still had several weeks to figure out how to get clean and have this baby.
The medical professional intervened. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the leg infection was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she left, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie delivered a infant weighing a small weight – premature, small but alive.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her pain relief did not work, her last dose of fentanyl had been administered a few hours prior to birth.
She felt unwell. Not ready for motherhood. 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 do the impossible. An OBGYN told her to “just” stop using. Even her supplier declined to supply to her when she became obviously with child.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her stop using only led to greater shame and self-abuse, a trigger 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 infant was moved to the NICU. When Stephanie finally saw her her, she was attached to tubes and leads, so tiny she thought she would harm her. Cradling her initially, she felt empty. “I just stared 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 give her child the name the same as her nurse, after the nurse who had been so kind to her.
Hospital staff told her about a care center, a innovative treatment home where women and their babies are treated together, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) regularly, infants are still rushed to special care and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like Maddie’s Place is demonstrating a key fact: when families are kept intact, results get better, custody cases decrease and overall savings increase.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, a couple of employees came to pick her up.
She left the medical center still in detox, fearful and unsure about what would come next.
At the facility, Stephanie still feared that authorities would come remove her daughter – even though she was not sure she wanted to keep her. The fear lingered: that at any time, someone could walk in and remove her child.
For the beginning period, Stephanie remained isolated. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about survival. Drugs came first; trust came last.
Stephanie had one close friend, but even that connection was tenuous. The those close to her always found ways to hurt her. She lacked the ability to value herself, much less anyone else.
Every day, staff from the center took her to a treatment center, given as medication. Slowly, she was beginning recovery.
She spent every minute outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with intolerance to some formulas and severe digestive problems. She needed nutritional guidance. She also had increased sensitivity and required an specialist – all frequent conditions for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I was capable. I could be a mom.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a peer support specialist, came over with her own family in tow to deliver baked goods. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a pompom on her head, seated on the ground with the exit nearby. She is thin. Her face is downcast so you cannot see her face. She is lifting the baby on her leg for the young ones to see and they are standing close, admiring and touching to the baby.
A young boy, eight, asked the mothers: “Where are all the dads?” The moms tried to explain that the fathers had obligations, engaged elsewhere, that they would be there if they could.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that infants need affection, then I could do this. I could parent.”
Approaches for managing infants affected by substances have existed for decades.
The assessment tool was developed in 1975|
