She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, a woman named Stephanie visited the ER after her infection worsened up her legs. Without a job or home, estranged from her family, she resided in a small structure she had built in a companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had used fentanyl before arriving at the hospital and had just enough time to get treated before she had to return to get high again. She thought she still had a month remaining to plan her recovery and give birth.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the leg infection was severe, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that abstinence might harm her and the baby. After delivery 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 delivered a daughter weighing 4lb 8oz – born before term, small but alive.
When the nurse asked if she wanted to embrace her child, Stephanie said “I cannot.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been administered a few hours prior to birth.
She felt sick. Unprepared to be a mother. Not fit.
Stephanie had tried to get clean repeatedly before birth, and felt horrible each time she was unsuccessful. She felt without value, criticizing herself for not being able to overcome the challenge. An doctor told her to “simply” stop using. Even her source would not provide to her when she became clearly expecting.
“Yet I was unable,” she said. “I had to seek support.”
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 use again. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The baby was taken to the NICU. When Stephanie finally saw her her, she was attached to tubes and leads, so little she thought she would harm her. Embracing her at last, she felt detached. “I just stared at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to call her daughter Izzie, after the attendant who showed compassion to her.
Hospital staff told her about a care center, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a developing system of centers like this facility is showing an important truth: when mothers and babies stay together, recovery succeeds, fewer children enter care and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility for the program, a couple of employees came to collect her.
She stepped out of the hospital still in withdrawal, scared and uncertain about what would come next.
At the facility, Stephanie still was concerned that CPS would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any point, someone could enter and remove her child.
For the first two weeks, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about getting by. Drugs came first; faith came last.
Stephanie had a single companion, but even that relationship was delicate. The people she loved always found ways to hurt her. She was unable to value herself, much less anyone else.
Each day, staff from Maddie’s Place transported her to a treatment center, provided orally. Over time, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with adverse reactions to milk and severe digestive problems. She needed dietary support. She also had sensory challenges and required an specialist – all common issues for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I could do this. I could parent.
On a day prior to the holiday, Stephanie sat in the visitation area, where parents in active addiction can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in admiration of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She has an image 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 head is tilted forward so you do not see her expression. She is lifting the baby on her leg for the other kids to see and they are crowding near, admiring and touching to the baby.
One child, eight, asked the mothers: “Where are all the dads?” The moms tried to explain that the fathers had obligations, engaged elsewhere, that they would be there given the chance.
“When I have kids,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and the specialist looked at each other. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I was able. I could parent.”
Tools for treating drug-exposed newborns have been available for years.
The evaluation method was established in 1975|