She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
Eight months pregnant and in severe pain, the expectant mother arrived at the hospital emergency room after a serious infection started to spread up her legs. Without a job or home, cut off from her relatives, she stayed in a makeshift shelter she had assembled in a friend’s yard. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She slumped forward and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had used fentanyl before seeking medical help and had just enough time to get treated before she was compelled to leave to get high again. She thought she still had several weeks to figure out how to get clean and deliver her child.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she left, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is often prescribed in substance abuse treatment.
Five days later, on 12 November 2022, Stephanie gave birth to a daughter weighing a small weight – early, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her epidural had failed, her final administration of fentanyl had been administered four hours before delivery.
She felt sick. Unprepared to be a mother. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she relapsed. She felt worthless, criticizing herself for not being able to do the impossible. An OBGYN told her to “simply” stop using. Even her source would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The pervasive expectation that her love for her baby would make her quit only led to deeper self-loathing and negative self-talk, a impetus for her to relapse. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.
The baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to medical equipment, so small she thought she would hurt her. Embracing her at last, she felt empty. “I gazed upon her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Two days later she decided to call her daughter after her caregiver, after the nurse who had been so kind to her.
Medical personnel told her about a specialized facility, a unique recovery environment where parents and infants affected by substance use are supported as a unit, not apart.
In numerous states, where a baby is identified with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still quickly moved to hospitals and given drugs while their mothers face child-protection investigations. But a small, growing network of centers like this facility is showing an important truth: when mothers and babies stay together, outcomes improve, fewer children enter care and long-term costs decline.
It took Stephanie some time to build confidence to call, but she finally did. After verifying her eligibility for the program, care providers came to collect her.
She departed the institution still in detox, scared and uncertain about what would follow.
At Maddie’s Place, Stephanie still worried that child services would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could walk in and separate them.
For the beginning period, Stephanie remained isolated. “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; trust came last.
Stephanie had a single companion, but even that relationship was delicate. The those close to her always found ways to let her down. She lacked the ability to value herself, much less anyone else.
Daily, staff from the facility drove her to a treatment center, administered in pill form. Gradually, she was starting to get clean.
She spent every minute when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and severe digestive problems. She needed nutritional guidance. She also had heightened sensory issues and required an specialist – all frequent conditions for babies affected by withdrawal.
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 sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a mentor, came over with her own five kids in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She holds a picture of the moment. She is wearing black pants and a hoodie, a cap with a decoration on her head, sitting on the wooden floor with the door behind her. She is slender. Her head is tilted forward so you miss her features. She is presenting her daughter on her knee for the children to see and they are crowding near, showing interest to the baby.
One child, eight, asked the mothers: “Why are there no men?” The moms tried to explain that the men were occupied, handling responsibilities, that they would be there if they could.
“Once I become a parent,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that newborns require care, then I was able. I would become a mother.”
Methods to address drug-exposed newborns have been used for a long time.
The assessment tool was created in 1975|
