She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Transformed Their Futures.
Pregnant and experiencing intense discomfort, the expectant mother went to the medical facility after her infection worsened up her legs. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had built in a companion's property. She was also addicted to fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She slumped forward and threw up.
Stephanie finally broke down. “I have to get out of here. I have to go home and get high.”
She had consumed opioids 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 figure out how to get clean and have this baby.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she walked out, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
After five days, on a day in November 2022, Stephanie delivered a daughter weighing 4lb 8oz – premature, little but surviving.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been provided shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she relapsed. She felt worthless, berating herself for not being able to overcome the challenge. An doctor told her to “simply” stop using. Even her source declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her recover only led to greater shame and self-harm, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could will away a persistent condition.
The baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to tubes and leads, so small 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 still wasn’t sure she wanted to be her mother.
Two days later she decided to call her daughter after her caregiver, after the nurse who had been so kind to her.
Hospital staff told her about a specialized facility, a unique recovery environment where women and their babies are treated together, not apart.
In many parts of America, where a baby is found to have infant withdrawal condition frequently, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a limited but expanding group of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, results get better, foster placements fall and long-term costs decline.
It took Stephanie a period to find strength 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 withdrawal, scared and uncertain about what would happen next.
At the facility, Stephanie still was concerned that CPS would come take Izzie – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could walk in and remove her child.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about getting by. Addiction came first; trust came last.
Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to cause pain. She lacked the ability to value herself, let alone anyone else.
Daily, staff from the facility drove her to a recovery program, given as medication. Gradually, she was starting to get clean.
She utilized each moment when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and obvious stomach troubles. She needed nutritional guidance. She also had increased sensitivity and required an specialist – all frequent conditions for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I was capable. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for monitored interactions with their babies. An advocate, a peer support specialist, stopped by with her own children in tow to deliver baked goods. They all gathered around Stephanie, who was resting on the carpet 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 overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is wearing casual attire, a gray knit hat with a decoration on her head, resting on the floor with the exit nearby. She is thin. Her head is tilted forward so you miss her features. She is presenting her daughter on her lap for the other kids to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the parents: “Where are all the dads?” The parents responded that the men were occupied, handling responsibilities, that they would be there given the chance.
“In the future,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and the specialist made eye contact. “I broke down,” Stephanie said. “If this little kid could see that infants need affection, then I found the courage. I would become a mother.”
Approaches for managing drug-exposed newborns have been used for a long time.
The evaluation method was developed in 1975|
