A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Transformed Their Futures.
In her eighth month of pregnancy and suffering, the expectant mother visited the hospital emergency room after an infection began spreading up her legs. Without a job or home, separated from loved ones, she stayed in a makeshift shelter she had built in a friend’s yard. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and get high.”
She had taken the drug before seeking medical help and had sufficient opportunity to get treated before she had to return to get high again. She thought she still had a month remaining to find a way to become sober and have this baby.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the leg infection was severe, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be switched to methadone, a drug that alleviates cravings and is often prescribed in rehabilitation.
A short time later, on a day in November 2022, Stephanie gave birth to a daughter weighing a small weight – born before term, tiny yet healthy.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “not now.” She was detached. 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. Unworthy.
Stephanie had sought recovery repeatedly before birth, and felt terrible each time she failed. She felt worthless, blaming herself for not being able to achieve the unattainable. An obstetrician told her to “simply” stop using. Even her supplier refused to sell to her when she became clearly expecting.
“Yet I was unable,” she said. “I needed help.”
The widespread belief that her affection for her child would make her recover only led to increased guilt and negative self-talk, a impetus for her to return to drugs. Yet she could not easily command her addiction away, any more than she could eliminate a chronic disease.
The newborn was transferred to the NICU. When Stephanie finally saw her her, she was connected to medical equipment, so little she thought she would harm her. Embracing her at last, she felt empty. “I gazed upon her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to give her child the name Izzie, after the nurse who had been so kind to her.
Nurses and doctors told her about Maddie’s Place, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In much of the US, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still whisked to NICUs and medicated while their mothers face custody evaluations. But a small, growing network of centers like this facility is demonstrating a key fact: when parents and infants remain united, outcomes improve, custody cases decrease 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, care providers came to pick her up.
She left the medical center still in withdrawal, anxious and doubtful 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 fear lingered: that at any time, someone could arrive and separate them.
For the first two weeks, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Homelessness, she said, was about survival. Drugs came first; faith came last.
Stephanie had a trusted ally, but even that connection was tenuous. The individuals she cared for always found ways to let her down. She was unable to value herself, much less anyone else.
Every day, staff from Maddie’s Place took her to a recovery program, provided orally. Gradually, she was starting to get clean.
She spent every minute beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and obvious stomach troubles. She needed dietary support. She also had increased sensitivity and required an professional – all frequent conditions for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I was capable. I could be a mom.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where parents in active addiction can come for supervised visits with their babies. An advocate, a mentor, visited with her own five kids in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in admiration of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She has an image of the moment. She is dressed in black pants and a hoodie, a beanie with a pompom on her head, resting on the floor with the exit nearby. She is slender. Her face is downcast so you do not see her expression. She is holding Izzie up on her leg for the young ones to see and they are crowding near, fawning and reaching out to the baby.
One child, eight, asked the parents: “Why are there no men?” The parents responded that the men were occupied, engaged elsewhere, that they would be there given the chance.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I became emotional,” Stephanie said. “If this little kid could see that newborns require care, then I was able. I could parent.”
Tools for treating babies with exposure have been used for a long time.
The Finnegan NAS scale was developed in 1975|
