She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
In her eighth month of pregnancy and suffering, the expectant mother arrived at the ER after an infection began spreading up her legs. Without a job or home, separated from loved ones, she lived in a shed she had constructed in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She slumped forward and threw up.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and use drugs.”
She had consumed opioids before seeking medical help 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 find a way to become sober and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the leg infection was serious, but doctors had discovered she also had an ruptured membrane. The nurse, her nurse, warned her: if she left, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is commonly used in addiction recovery.
A short time later, on 12 November 2022, Stephanie had a daughter weighing 4lb 8oz – early, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been provided a few hours prior to birth.
She felt ill. Ill-equipped for parenting. Unworthy.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she relapsed. She felt without value, blaming herself for not being able to overcome the challenge. An OBGYN told her to “simply” stop using. Even her supplier declined to supply to her when she became clearly expecting.
“Yet I was unable,” she said. “I required assistance.”
The widespread belief that her love for her baby would make her recover only led to increased guilt and self-abuse, a impetus for her to return to drugs. Yet she could not simply will her addiction away, any more than she could overcome a long-term illness.
The infant was moved to the special care nursery. When Stephanie at last met her, she was attached to medical equipment, so little she thought she would harm her. Embracing her at last, she felt empty. “I looked at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the professional who provided support to her.
Medical personnel told her about Maddie’s Place, a unique recovery environment where parents and infants affected by substance use are treated together, not apart.
In numerous states, where a baby is found to have infant withdrawal condition every 18 minutes, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a small, growing network of centers like the care home is demonstrating a key fact: when mothers and babies stay together, results get better, custody cases decrease and future expenses reduce.
It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, two staff members came to bring her to the facility.
She departed the institution still in withdrawal, scared and uncertain about what would follow.
At the facility, Stephanie still was concerned that CPS would come seize her child – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could enter and remove her child.
For the initial fortnight, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Addiction came first; reliance came last.
Stephanie had one close friend, but even that bond was fragile. The people she loved always found ways to cause pain. She did not know how to care for herself, not to mention anyone else.
Daily, staff from Maddie’s Place took her to a clinic for methadone, provided orally. Slowly, 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 girl had some trouble feeding at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had sensory challenges and required an professional – all frequent conditions for babies exposed to substances.
Seeing that even a young person understands the need for care, then I was capable. I could be a mom.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. A support specialist, a peer support specialist, came over with her own five kids in tow to deliver baked goods. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in awe of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She holds a picture of the moment. She is wearing casual attire, a gray knit hat with a bobble on her head, resting on the floor with the exit nearby. She is slender. Her face is downcast so you miss her features. She is holding Izzie up on her leg for the young ones to see and they are gathered around, showing interest to the baby.
One child, eight, asked the mothers: “Why are there no men?” The women attempted to clarify that the dads were busy, engaged elsewhere, that they would be there if possible.
“In the future,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and Bunch-Smith made eye contact. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that newborns require care, then I could do this. I could parent.”
Approaches for managing drug-exposed newborns have been used for a long time.
The assessment tool was created in 1975|
