She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the medical facility after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had built in a acquaintance's garden. She was also addicted to fentanyl.
As doctors treated her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and vomited.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and use drugs.”
She had used fentanyl before seeking medical help and had just enough time to get treated before she needed to go home to get high again. She thought she still had a month remaining to plan her recovery and have this baby.
The medical professional intervened. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was severe, but doctors had discovered she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a medication that eases withdrawal and is often prescribed in addiction recovery.
Five days later, on a day in November 2022, Stephanie had a infant weighing just over four pounds – early, tiny yet healthy.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her anesthesia was ineffective, her last dose of fentanyl had been administered four hours before delivery.
She felt ill. Unprepared to be a mother. Undeserving.
Stephanie had tried to get clean several times during pregnancy, and felt terrible each time she was unsuccessful. She felt worthless, berating herself for not being able to achieve the unattainable. An doctor told her to “only” stop using. Even her dealer declined to supply to her when she became obviously with child.
“However, I failed,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her quit only led to greater shame 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 tubes and leads, so small she thought she would hurt her. Embracing her at last, she felt empty. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to call her daughter the same as her nurse, after the professional who provided support to her.
Nurses and doctors told her about a care center, a new kind of care center 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 frequently, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face child-protection investigations. But a limited but expanding group of centers like Maddie’s Place is showing an important truth: when parents and infants remain united, recovery succeeds, fewer children enter care and overall savings increase.
It took Stephanie a while to gather the courage to call, but she finally did. After verifying her eligibility for the program, care providers came to pick her up.
She departed the institution still in recovery, anxious and doubtful about what would happen next.
At Maddie’s Place, Stephanie still feared that CPS would come take Izzie – even though she was not sure she wanted to keep her. The anxiety remained: that at any moment, someone could enter and separate them.
For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Substances came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The individuals she cared for always found ways to cause pain. She did not know how to value herself, let alone anyone else.
Daily, staff from the center took her to a clinic for methadone, given as medication. Gradually, she was beginning recovery.
She utilized each moment outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed nutritional guidance. She also had sensory challenges and required an specialist – all typical problems for babies exposed to substances.
Seeing that even a young person understands the need for care, then I could do this. I could be a mom.
During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. A support specialist, a peer support specialist, stopped by with her own five kids in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She holds a picture of the moment. She is wearing black pants and a hoodie, a cap with a pompom on her head, resting on the floor with the exit nearby. She is slender. Her face is downcast so you cannot see her face. She is presenting her daughter on her knee for the children to see and they are standing close, fawning and reaching out 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.
“In the future,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist looked at each other. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I could be a mom.”
Methods to address babies with exposure have been available for years.
The Finnegan NAS scale was established in 1975|
