She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
Eight months pregnant and in severe pain, the expectant mother arrived at the medical facility after an infection began spreading up her legs. Without a job or home, estranged from her family, she stayed in a makeshift shelter she had constructed in a acquaintance's garden. She was also addicted to fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Withdrawal was setting in. She leaned over the bed and threw up.
Stephanie ultimately gave in. “I need to leave. I have to go home and get high.”
She had used fentanyl before arriving at the hospital and had sufficient opportunity to get treated before she needed to go home to get high again. She thought she still had a month remaining to figure out how to get clean and have this baby.
The medical professional intervened. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the medical facility declined to release her: the leg infection was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she walked out, she and her baby would not survive.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
Five days later, on a day in November 2022, Stephanie delivered a daughter weighing a small weight – early, tiny yet healthy.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been given a few hours prior to birth.
She felt sick. Unprepared to be a mother. Unworthy.
Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she was unsuccessful. She felt worthless, blaming herself for not being able to do the impossible. An doctor told her to “only” stop using. Even her supplier declined to supply to her when she became visibly pregnant.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her love for her baby would make her quit only led to increased guilt and self-abuse, a trigger for her to relapse. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The baby was taken to the neonatal intensive care unit. When Stephanie finally saw her her, she was attached to tubes and leads, so small she thought she would harm her. Embracing her at last, she felt detached. “I gazed upon 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 name her baby after her caregiver, after the attendant who showed compassion to her.
Nurses and doctors told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a developing system of centers like the care home is proving a simple point: when parents and infants remain united, results get better, foster placements fall and future expenses reduce.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After ensuring she qualified for the program, a couple of employees came to pick her up.
She departed the institution still in withdrawal, fearful and unsure about what would follow.
At the facility, Stephanie still worried that CPS would come take Izzie – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could enter and separate them.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about enduring. Drugs came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to hurt her. She was unable to value herself, not to mention anyone else.
Every day, staff from Maddie’s Place transported her to a recovery program, administered in pill form. Gradually, she was beginning recovery.
She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and severe digestive problems. She needed dietary support. She also had sensory challenges and required an professional – all common issues for babies born with NAS.
When a child recognizes these infants need affection, then I could do this. I would become a mother.
On a day prior to the holiday, Stephanie was in the common room, where parents in active addiction can come for monitored interactions with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own children in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in wonder of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She keeps a photo of the moment. She is dressed in black pants and a hoodie, a gray knit hat with a pompom on her head, seated on the ground with the entryway at her back. She is lean. Her face is downcast so you cannot see her face. She is lifting the baby on her lap for the young ones to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the parents: “What about the fathers?” The parents responded that the fathers had obligations, handling responsibilities, that they would be there if they could.
“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 made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that newborns require care, then I was able. I could parent.”
Tools for treating drug-exposed newborns have been available for years.
The evaluation method was developed in 1975|
