She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
Pregnant and experiencing intense discomfort, a woman named Stephanie went to the ER after an infection began spreading up her legs. Without a job or home, separated from loved ones, she resided in a small structure she had built in a friend’s yard. She was also addicted to fentanyl.
As medical staff managed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie finally broke down. “I have to get out of here. I have to go home and take a hit.”
She had used fentanyl before arriving at the hospital and had sufficient opportunity to get treated before she had to return to relapse. She thought she still had four weeks left to find a way to become sober and give birth.
The nurse had other ideas. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was critical, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she left, 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. Post-birth Stephanie would be placed on methadone, a medication that eases withdrawal and is often prescribed in substance abuse treatment.
After five days, on 12 November 2022, Stephanie delivered a infant weighing just over four pounds – born before term, small but alive.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been provided a few hours prior to birth.
She felt unwell. Unprepared to be a mother. Unworthy.
Stephanie had tried to get clean multiple times while expecting, and felt terrible each time she was unsuccessful. She felt hopeless, berating herself for not being able to do the impossible. An doctor told her to “simply” stop using. Even her supplier declined to supply to her when she became obviously with child.
“However, I failed,” she said. “I required assistance.”
The common assumption that her love for her baby would make her recover only led to deeper self-loathing and self-harm, a trigger for her to relapse. Yet she could not simply will her addiction away, any more than she could will away a persistent condition.
The infant was moved to the neonatal intensive care unit. When Stephanie finally saw her her, she was attached to medical equipment, so little she thought she would hurt her. Embracing her at last, she felt detached. “I just stared at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to call her daughter Izzie, after the nurse who had been so kind to her.
Medical personnel told her about Maddie’s Place, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In much of the US, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a limited but expanding group of centers like this facility is proving a simple point: when mothers and babies stay together, results get better, fewer children enter care and overall savings increase.
It took Stephanie a period to find strength to call, but she eventually made the call. 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, fearful and unsure about what would follow.
At the care center, Stephanie still feared that authorities would come take Izzie – even though she was not sure she wanted to keep her. The fear lingered: that at any time, someone could walk in and take her baby away.
For the first two weeks, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about getting by. Drugs came first; trust came last.
Stephanie had a trusted ally, but even that relationship was delicate. The those close to her always found ways to cause pain. She did not know how to care for herself, let alone anyone else.
Daily, staff from Maddie’s Place transported her to a clinic for methadone, administered in pill form. Slowly, 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 girl had some trouble feeding at first, with sensitivity to certain foods and obvious stomach troubles. She needed feeding therapy. She also had increased sensitivity and required an professional – all typical problems for babies affected by withdrawal.
When a child recognizes these infants need affection, then I was capable. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a recovery coach, came over with her own five kids in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the small baby 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 holds a picture of the moment. She is wearing dark trousers and a sweatshirt, a beanie with a bobble on her head, resting on the floor with the entryway at her back. She is thin. Her face is downcast so you miss her features. She is holding Izzie up on her lap for the other kids to see and they are crowding near, showing interest to the baby.
A young boy, eight, asked the parents: “What about the fathers?” The moms tried to explain that the fathers had obligations, called away to other tasks, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that infants need affection, then I was able. I could be a mom.”
Approaches for managing infants affected by substances have been available for years.
The Finnegan NAS scale was established in 1975|