A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Transformed Their Futures.
Eight months pregnant and in severe pain, the expectant mother went to the hospital emergency room after her infection worsened up her legs. Without a job or home, estranged from her family, 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. The onset of withdrawal began. She leaned over the bed and vomited.
Stephanie ultimately gave in. “Listen, I gotta go. 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 needed to go home to use once more. She thought she still had a month remaining to figure out how to get clean and have this baby.
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 infection in her legs was severe, but physicians found she also had an ruptured membrane. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in addiction recovery.
Five days later, on 12 November 2022, Stephanie had a daughter weighing just over four pounds – born before term, small but alive.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been administered a few hours prior to birth.
She felt sick. Not ready for motherhood. Unworthy.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she was unsuccessful. She felt without value, blaming herself for not being able to do the impossible. An OBGYN told her to “simply” stop using. Even her source declined to supply to her when she became visibly pregnant.
“However, I failed,” she said. “I had to seek support.”
The widespread belief that her love for her baby would make her stop using only led to greater shame and self-abuse, a impetus for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.
The baby was taken to the NICU. When Stephanie eventually visited her, she was connected to monitors, so small she thought she would break her. Holding her for the first time, she felt detached. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
After two days she decided to name her baby after her caregiver, after the professional who provided support to her.
Hospital staff told her about Maddie’s Place, a innovative treatment home where women and their babies are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition frequently, infants are still whisked to NICUs and medicated 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 mothers and babies stay together, results get better, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After confirming she would be a good fit for the program, care providers came to pick her up.
She stepped out of the hospital still in recovery, fearful and unsure about what would follow.
At the facility, Stephanie still worried that child services would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could enter and take her baby away.
For the initial fortnight, Stephanie remained isolated. “I preferred to be alone,” she said. “I was suspicious 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 individuals she cared for always found ways to cause pain. She lacked the ability to value herself, much less anyone else.
Each day, staff from the facility transported her to a recovery program, provided orally. Gradually, she was starting to get clean.
She spent every minute when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with intolerance to some formulas and obvious stomach troubles. She needed nutritional guidance. She also had heightened sensory issues and required an professional – all common issues for babies born with NAS.
Seeing that even a young person understands the need for care, then I was capable. I would become a mother.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own children in tow to bring treats. They all crowded near 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 showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She holds a picture 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 entryway at her back. She is slender. Her head is tilted forward so you cannot see her face. She is lifting the baby on her knee for the young ones to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the parents: “Why are there no men?” The moms tried to explain that the fathers had obligations, handling responsibilities, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and her companion looked at each other. “I broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I could be a mom.”
Methods to address drug-exposed newborns have existed for decades.
The assessment tool was established in 1975|
