She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
In her eighth month of pregnancy and suffering, the expectant mother arrived at the medical facility after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she stayed in a makeshift shelter she had assembled in a acquaintance's garden. She was also hooked on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Withdrawal was setting in. She bent over the bedside and vomited.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before coming to the ER 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 figure out how to get clean and deliver her child.
The nurse had other ideas. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the leg infection was severe, but doctors had discovered she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a medication that eases withdrawal and is often prescribed in addiction recovery.
After five days, on 12 November 2022, Stephanie gave birth to a infant weighing a small weight – born before term, small but alive.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her epidural had failed, her final administration of fentanyl had been administered a few hours prior to birth.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had tried to get clean multiple times while expecting, and felt awful each time she relapsed. She felt worthless, berating herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her supplier would not provide to her when she became clearly expecting.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her love for her baby would make her stop using only led to deeper self-loathing and self-harm, a cause for her to return to drugs. Yet she could not simply will her addiction away, any more than she could will away a chronic disease.
The newborn was transferred to the NICU. When Stephanie finally saw her her, she was attached to monitors, so tiny she thought she would hurt her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to name her baby after her caregiver, after the attendant who showed compassion to her.
Nurses and doctors told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is identified with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a limited but expanding group of centers like the care home is showing an important truth: when families are kept intact, recovery succeeds, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to pick her up.
She departed the institution still in detox, anxious and doubtful about what would happen next.
At the facility, 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 walk in and remove her child.
For the initial fortnight, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” 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 one close friend, but even that bond was fragile. The those close to her always found ways to hurt her. She lacked the ability to value herself, much less anyone else.
Daily, staff from the center transported her to a clinic for methadone, provided orally. Gradually, she was starting to get clean.
She spent every minute outside treatment with Izzie, and could see that her baby was obtaining necessary support 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 increased sensitivity and required an occupational therapist – all typical problems for babies born with NAS.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. A support specialist, a recovery coach, stopped by with her own children in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She has an image of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a pompom on her head, resting on the floor with the entryway at her back. She is lean. Her face is downcast so you miss her features. She is presenting her daughter on her knee for the other kids to see and they are gathered around, fawning and reaching out to the baby.
One child, eight, asked the mothers: “Where are all the dads?” The moms tried to explain that the dads were busy, handling responsibilities, that they would be there if possible.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and the specialist looked at each other. “I broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I was able. I could be a mom.”
Methods to address drug-exposed newborns have been available for years.
The assessment tool was created in 1975|
