She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the ER after a serious infection started to spread up her legs. Jobless and without shelter, separated from loved ones, she resided in a small structure she had assembled in a friend’s yard. She was also hooked on fentanyl.
As doctors treated her infection, she started to feel anxious. The onset of withdrawal began. She slumped forward and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and get high.”
She had consumed opioids before seeking medical help and had sufficient opportunity 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 deliver her child.
The nurse had other ideas. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was severe, but physicians found she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie delivered a daughter weighing a small weight – born before term, small but alive.
When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was detached. Her pain relief did not work, her last dose of fentanyl had been provided a few hours prior to birth.
She felt unwell. Unprepared to be a mother. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she failed. She felt without value, berating herself for not being able to achieve the unattainable. An obstetrician told her to “just” stop using. Even her supplier refused to sell to her when she became visibly pregnant.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her quit only led to increased guilt and self-abuse, a impetus for her to use again. Yet she could not easily command her addiction away, any more than she could overcome a persistent condition.
The baby was taken to the NICU. When Stephanie eventually visited her, she was attached to tubes and leads, so small she thought she would harm her. Holding her for the first time, she felt detached. “I just stared at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Two days later she decided to call her daughter the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, 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 newborn addiction symptoms frequently, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when families are kept intact, results get better, fewer children enter care and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After ensuring she qualified for the program, two staff members came to collect her.
She left the medical center still in withdrawal, anxious and doubtful about what would come next.
At Maddie’s Place, Stephanie still feared that CPS would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could arrive and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I was suspicious at that point.”
Homelessness, she said, was about enduring. Drugs came first; faith came last.
Stephanie had a trusted ally, but even that connection was tenuous. The those close to her always found ways to let her down. She lacked the ability to love herself, not to mention anyone else.
Each day, staff from the center transported her to a recovery program, given as medication. Over time, she was beginning recovery.
She utilized each moment outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an occupational therapist – all common issues for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could be a mom.
On a day prior to the holiday, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. An advocate, a recovery coach, came over with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in wonder of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She keeps a photo of the moment. She is wearing casual attire, a gray knit hat with a pompom on her head, resting on the floor with the entryway at her back. She is lean. Her head is tilted forward so you miss her features. She is lifting the baby on her leg for the young ones to see and they are crowding near, showing interest to the baby.
A young boy, eight, asked the moms: “Why are there no men?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there given the chance.
“In the future,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist looked at each other. “I just lost it and fell apart,” Stephanie said. “When a child recognized that infants need affection, then I could do this. I could be a mom.”
Methods to address babies with exposure have been used for a long time.
The Finnegan NAS scale was established in 1975|
