A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
Eight months pregnant and in severe pain, the expectant mother arrived at the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had built in a companion's property. She was also addicted to fentanyl.
As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She slumped forward and threw up.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and get high.”
She had used fentanyl before seeking medical help and had only a brief window to get treated before she had to return to relapse. She thought she still had a month remaining to plan her recovery and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was severe, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is commonly used in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie had a infant weighing a small weight – premature, tiny yet healthy.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was detached. Her pain relief did not work, her final administration of fentanyl had been administered a few hours prior to birth.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean several times during pregnancy, and felt horrible each time she was unsuccessful. She felt worthless, berating herself for not being able to achieve the unattainable. An doctor told her to “just” stop using. Even her supplier refused to sell to her when she became obviously with child.
“Yet I was unable,” she said. “I had to seek support.”
The pervasive expectation that her love for her baby would make her recover only led to increased guilt and negative self-talk, a trigger for her to use again. Yet she could not simply will her addiction away, any more than she could will away a chronic disease.
The infant was moved to the neonatal intensive care unit. When Stephanie finally saw her her, she was connected to monitors, so small she thought she would hurt her. Embracing her at last, she felt detached. “I just stared at 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 give her child the name Izzie, after the professional who provided support to her.
Nurses and doctors told her about Maddie’s Place, a innovative treatment home where mothers and their drug-exposed newborns are cared for jointly, not apart.
In many parts of America, where a baby is identified with infant withdrawal condition regularly, infants are still whisked to NICUs and given drugs while their mothers face custody evaluations. But a small, growing network of centers like the care home is proving a simple point: when mothers and babies stay together, outcomes improve, foster placements fall and overall savings increase.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to pick her up.
She left the medical center still in detox, scared and uncertain about what would happen next.
At the care center, Stephanie still worried that authorities would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could arrive and take her baby away.
For the first two weeks, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about survival. Substances came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She lacked the ability to value herself, not to mention anyone else.
Each day, staff from the facility drove her to a clinic for methadone, given as medication. Gradually, she was embracing sobriety.
She devoted all her time when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and obvious stomach troubles. She needed feeding therapy. She also had increased sensitivity and required an specialist – all typical problems for babies born with NAS.
Seeing that even a young person understands the need for care, then I was capable. I could parent.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for monitored interactions with their babies. A support specialist, a peer support specialist, came over with her own five kids in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in awe of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She has an image of the moment. She is dressed in dark trousers and a sweatshirt, a gray knit hat with a pompom on her head, seated on the ground with the door behind her. She is slender. Her face is downcast so you miss her features. She is holding Izzie up on her lap for the other kids to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the mothers: “What about the fathers?” The parents responded that the men were occupied, engaged elsewhere, 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 Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I could be a mom.”
Methods to address infants affected by substances have been available for years.
The assessment tool was established in 1975|