She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
In her eighth month of pregnancy and suffering, the expectant mother went to the medical facility after a serious infection started to spread up her legs. Jobless and without shelter, separated from loved ones, she resided in a small structure she had built in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. She slumped forward and threw up.
Stephanie eventually collapsed. “I need to leave. I have to go home and get high.”
She had taken the drug before arriving at the hospital and had sufficient opportunity to get treated before she had to return to get high again. She thought she still had several weeks to plan her recovery and have this baby.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the leg infection was critical, but physicians found she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, she and her baby would not survive.
She encouraged the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a drug that alleviates cravings and is commonly used in rehabilitation.
A short time later, on 12 November 2022, Stephanie delivered a infant weighing just over four pounds – early, tiny yet healthy.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her pain relief did not work, her final administration of fentanyl had been given shortly before she gave birth.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she was unsuccessful. She felt without value, berating herself for not being able to achieve the unattainable. An obstetrician told her to “simply” stop using. Even her source declined to supply to her when she became obviously with child.
“Yet I was unable,” she said. “I had to seek support.”
The common assumption that her affection for her child would make her stop using only led to deeper self-loathing and self-harm, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could eliminate a persistent condition.
The baby was taken to the special care nursery. When Stephanie eventually visited her, she was hooked up to tubes and leads, so tiny she thought she would hurt her. Cradling her initially, she felt detached. “I just stared at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to call her daughter the same as her nurse, after the attendant who showed compassion to her.
Medical personnel told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a limited but expanding group of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, outcomes improve, foster placements fall and long-term costs decline.
It took Stephanie a period to find strength 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 stepped out of the hospital still in withdrawal, scared and uncertain about what would follow.
At the care center, Stephanie still feared that CPS would come remove her daughter – even though she was hesitant about parenting. The concern persisted: that at any point, someone could enter and take her baby away.
For the first two weeks, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Substances came first; trust came last.
Stephanie had a single companion, but even that relationship was delicate. The people she loved always found ways to cause pain. She lacked the ability to care for herself, let alone anyone else.
Every day, staff from the center took her to a clinic for methadone, 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 obtaining necessary support she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and obvious stomach troubles. She needed nutritional guidance. She also had increased sensitivity and required an professional – all frequent conditions for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could parent.
On a day prior to the holiday, Stephanie was in the common room, where those still using can come for supervised visits with their babies. An advocate, a mentor, came over with her own family in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The young ones stared in awe of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She has an image of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a bobble on her head, sitting on the wooden floor with the door behind her. She is slender. Her face is downcast so you miss her features. She is holding Izzie up on her leg for the other kids to see and they are gathered around, admiring and touching to the baby.
A young boy, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the fathers had obligations, 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. They will know they are valued.”
Stephanie and the specialist looked at each other. “I just lost it and fell apart,” Stephanie said. “When a child recognized that infants need affection, then I was able. I could parent.”
Tools for treating babies with exposure have existed for decades.
The assessment tool was created in 1975|
