She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Transformed Their Futures.
Pregnant and experiencing intense discomfort, a woman named Stephanie went to the ER after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she lived in a shed she had built in a friend’s yard. She was also hooked on fentanyl.
As physicians addressed her infection, she began to panic. The onset of withdrawal began. She slumped forward and vomited.
Stephanie eventually collapsed. “I need to leave. I have to go home and use drugs.”
She had consumed opioids before coming to the ER and had just enough time to get treated before she needed to go home to use once more. She thought she still had several weeks to figure out how to get clean and have this baby.
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 infection in her legs was serious, but doctors had discovered she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a medication that eases withdrawal and is frequently utilized in rehabilitation.
A short time later, on 12 November 2022, Stephanie gave birth to a infant weighing just over four pounds – premature, little but surviving.
When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her epidural had failed, her previous intake of fentanyl had been provided four hours before delivery.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she was unsuccessful. She felt hopeless, blaming herself for not being able to achieve the unattainable. An OBGYN told her to “simply” stop using. Even her source declined to supply to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The widespread belief that her affection for her child would make her recover only led to greater shame 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 neonatal intensive care unit. When Stephanie at last met her, she was connected to monitors, so little she thought she would harm her. Holding her for the first time, she felt empty. “I looked at her and was like, ‘How will I care for you?’” She continued to doubt 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 new kind of care center where women and their babies are treated together, not apart.
In much of the US, where a baby is diagnosed with neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a small, growing network of centers like this facility is showing an important truth: when mothers and babies stay together, recovery succeeds, custody cases decrease and overall savings increase.
It took Stephanie some time to build confidence to call, but she finally did. After ensuring she qualified for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in recovery, anxious and doubtful about what would happen next.
At the care center, Stephanie still was concerned that authorities would come seize her child – even though she was hesitant about parenting. The concern persisted: that at any moment, someone could walk in and take her baby away.
For the first two weeks, Stephanie kept to herself. “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.”
Survival outdoors, she said, was about survival. Addiction came first; trust came last.
Stephanie had a trusted ally, but even that relationship was delicate. The those close to her always found ways to hurt her. She was unable to care for herself, much less anyone else.
Daily, staff from the center drove her to a recovery program, given as medication. Slowly, she was beginning recovery.
She utilized each moment when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and obvious stomach troubles. She needed dietary support. She also had sensory challenges and required an specialist – all frequent conditions for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could parent.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. Katie Bunch-Smith, a mentor, came over with her own children in tow to bring treats. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She holds a picture of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a decoration on her head, resting on the floor with the entryway at her back. She is slender. Her head is tilted forward so you miss her features. She is lifting the baby on her lap for the other kids to see and they are crowding near, fawning and reaching out to the baby.
Jacob, eight, asked the parents: “Where are all the dads?” The parents responded that the fathers had obligations, called away to other tasks, 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 her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I could be a mom.”
Tools for treating babies with exposure have been used for a long time.
The assessment tool was established in 1975|
