A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, a woman named Stephanie arrived at the ER after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she lived in a shed she had built in a companion's property. She was also addicted to fentanyl.
As medical staff managed her infection, she started to feel anxious. The onset of withdrawal began. She bent over the bedside and threw up.
Stephanie ultimately gave in. “I need to leave. I have to go home and take a hit.”
She had consumed opioids before arriving at the hospital and had sufficient opportunity to get treated before she was compelled to leave to get high again. She thought she still had a month remaining 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 condition in her limbs was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be placed on methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.
A short time later, on a day in November 2022, Stephanie had a daughter weighing 4lb 8oz – premature, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her epidural had failed, her previous intake of fentanyl had been provided shortly before she gave birth.
She felt unwell. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery several times during pregnancy, and felt terrible each time she was unsuccessful. She felt without value, criticizing herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her source would not provide to her when she became obviously with child.
“However, I failed,” she said. “I required assistance.”
The common assumption that her bond with her newborn would make her recover only led to greater shame and self-harm, a trigger for her to return to drugs. Yet she could not simply will her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the NICU. When Stephanie at last met her, she was hooked up to monitors, so little she thought she would break her. Cradling her initially, she felt detached. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to give her child the name after her caregiver, after the nurse who had been so kind to her.
Medical personnel told her about Maddie’s Place, a innovative treatment home where women and their babies are cared for jointly, not apart.
In many parts of America, where a baby is identified with infant withdrawal condition frequently, infants are still quickly moved to hospitals and medicated while their mothers face parental assessments. But a limited but expanding group of centers like this facility is demonstrating a key fact: when parents and infants remain united, outcomes improve, fewer children enter care and long-term costs decline.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility for the program, two staff members came to collect her.
She stepped out of the hospital still in recovery, fearful and unsure about what would happen next.
At the facility, Stephanie still worried that child services would come remove her daughter – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could arrive and separate them.
For the first two weeks, Stephanie stayed withdrawn. “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.”
Life on the streets, she said, was about survival. Substances came first; trust came last.
Stephanie had one close friend, but even that relationship was delicate. The those close to her always found ways to cause pain. She was unable to care for herself, let alone anyone else.
Each day, staff from Maddie’s Place drove her to a clinic for methadone, given as medication. Over time, she was beginning recovery.
She spent every minute beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an specialist – all typical problems for babies born with NAS.
Seeing that even a young person understands the need for care, then I could do this. I could be a mom.
On a day prior to the holiday, Stephanie was in the common room, where those still using can come for guided meetings with their babies. An advocate, a peer support specialist, came over with her own five kids in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in black pants and a hoodie, a cap with a bobble on her head, resting on the floor with the exit nearby. She is thin. Her head is tilted forward so you cannot see her face. She is lifting the baby on her knee for the children to see and they are crowding near, fawning and reaching out to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The parents responded that the fathers had obligations, engaged elsewhere, that they would be there if they could.
“When I have kids,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and Bunch-Smith made eye contact. “I broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I could do this. I would become a mother.”
Approaches for managing drug-exposed newborns have been available for years.
The assessment tool was created in 1975|
