A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Rescued Both Lives.
Pregnant and experiencing intense discomfort, a woman named Stephanie visited the hospital emergency room after an infection began spreading up her legs. Unemployed and homeless, separated from loved ones, she stayed in a makeshift shelter she had constructed in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had taken the drug before seeking medical help and had sufficient opportunity to get treated before she was compelled to leave to get high again. She thought she still had several weeks to plan her recovery and give birth.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was serious, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she left, she and her baby would not survive.
She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be transitioned to methadone, a drug that alleviates cravings and is often prescribed in addiction recovery.
A short time later, on 12 November 2022, Stephanie had a infant weighing 4lb 8oz – premature, little but surviving.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been given shortly before she gave birth.
She felt unwell. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt horrible each time she relapsed. She felt without value, berating herself for not being able to overcome the challenge. An OBGYN told her to “simply” stop using. Even her supplier refused to sell to her when she became visibly pregnant.
“But I couldn’t,” 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 self-harm, a cause for her to relapse. Yet she could not just wish her addiction away, any more than she could will away a persistent condition.
The baby was taken to the neonatal intensive care unit. When Stephanie finally saw her her, she was connected to tubes and leads, so little she thought she would hurt her. Embracing her at last, she felt empty. “I looked at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to call her daughter Izzie, after the nurse who had been so kind to her.
Medical personnel told her about Maddie’s Place, a new kind of care center where parents and infants affected by substance use are supported as a unit, not apart.
In much of the US, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a developing system of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, outcomes improve, fewer children enter care and overall savings increase.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, a couple of employees came to bring her to the facility.
She left the medical center still in withdrawal, anxious and doubtful about what would happen next.
At Maddie’s Place, Stephanie still worried that child services would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any time, someone could enter and separate them.
For the beginning period, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about getting by. Drugs came first; faith came last.
Stephanie had a trusted ally, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She did not know how to care for herself, much less anyone else.
Each day, staff from the center took her to a recovery program, given as medication. Gradually, she was embracing sobriety.
She spent every minute when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and obvious stomach troubles. She needed feeding therapy. She also had sensory challenges and required an occupational therapist – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I was capable. I would become a mother.
On a day prior to the holiday, Stephanie was in the common room, where those still using can come for monitored interactions with their babies. An advocate, a recovery coach, visited with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The young ones stared in awe of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She holds a picture of the moment. She is clad in casual attire, a cap with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is lean. Her face is downcast so you do not see her expression. She is lifting the baby on her leg for the young ones to see and they are standing close, fawning and reaching out to the baby.
Jacob, eight, asked the parents: “Where are all the dads?” The parents responded that the dads were busy, handling responsibilities, that they would be there if they could.
“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 the specialist looked at each other. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that infants need affection, then I could do this. I could be a mom.”
Tools for treating babies with exposure have existed for decades.
The evaluation method was developed in 1975|
