A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Transformed Their Futures.
Pregnant and experiencing intense discomfort, a woman named Stephanie arrived at the ER after her infection worsened up her legs. Jobless and without shelter, estranged from her family, she lived in a shed she had built in a acquaintance's garden. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and vomited.
Stephanie eventually collapsed. “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 sufficient opportunity to get treated before she needed to go home to get high again. She thought she still had several weeks to figure out how to get clean and deliver her child.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that symptoms could threaten 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 a day in November 2022, Stephanie had a daughter weighing 4lb 8oz – born before term, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “not now.” She was emotionless. Her pain relief did not work, her previous intake of fentanyl had been provided shortly before she gave birth.
She felt ill. Not ready for motherhood. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she was unsuccessful. She felt hopeless, berating herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her supplier declined to supply to her when she became obviously with child.
“Yet I was unable,” she said. “I required assistance.”
The common assumption that her love for her baby would make her stop using only led to greater shame and self-abuse, a impetus for her to return to drugs. Yet she could not easily command her addiction away, any more than she could overcome a long-term illness.
The infant was moved to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to monitors, so tiny she thought she would hurt her. Embracing her at last, she felt empty. “I just stared at her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to name her baby after her caregiver, after the nurse who had been so kind to her.
Medical personnel told her about a care center, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In many parts of America, where a baby is found to have neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and given drugs while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when parents and infants remain united, outcomes improve, fewer children enter care and future expenses reduce.
It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, a couple of employees came to bring her to the facility.
She departed the institution still in withdrawal, anxious and doubtful about what would happen next.
At the care center, Stephanie still was concerned that CPS would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could walk in and separate them.
For the initial fortnight, Stephanie remained isolated. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about survival. Substances came first; reliance came last.
Stephanie had a trusted ally, but even that connection was tenuous. The individuals she cared for always found ways to cause pain. She did not know how to value herself, much less anyone else.
Daily, staff from the facility took her to a treatment center, given as medication. Over time, she was embracing sobriety.
She devoted all her time 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 adverse reactions to milk and obvious stomach troubles. She needed feeding therapy. She also had heightened sensory issues and required an specialist – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I was capable. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a mentor, visited with her own children in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in wonder of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She has an image of the moment. She is wearing dark trousers and a sweatshirt, a beanie with a bobble on her head, seated on the ground with the door behind her. She is slender. Her posture is humble so you cannot see her face. She is presenting her daughter on her knee for the children to see and they are standing close, showing interest to the baby.
One child, eight, asked the moms: “Why are there no men?” The parents responded that the men were occupied, called away to other tasks, that they would be there if they could.
“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 Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I could parent.”
Methods to address drug-exposed newborns have been available for years.
The evaluation method was created in 1975|
