A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie visited the ER after her infection worsened up her legs. Without a job or home, separated from loved ones, she lived in a shed she had constructed in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and threw up.
Stephanie finally broke down. “I need to leave. I have to go home and take a hit.”
She had taken the drug before seeking medical help and had sufficient opportunity to get treated before she needed to go home to relapse. 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 staying put.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the leg infection was severe, but doctors had discovered she also had an ruptured membrane. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in addiction recovery.
After five days, on 12 November 2022, Stephanie delivered a infant weighing just over four pounds – early, small but alive.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was emotionless. Her anesthesia was ineffective, her last dose of fentanyl had been provided shortly before she gave birth.
She felt ill. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she failed. She felt hopeless, berating herself for not being able to overcome the challenge. An obstetrician told her to “just” stop using. Even her supplier would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The common assumption that her bond with her newborn would make her recover only led to greater shame 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 infant was moved to the NICU. When Stephanie eventually visited her, she was connected to medical equipment, so little she thought she would hurt her. Holding her for the first time, she felt empty. “I just stared at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Two days later she decided to name her baby after her caregiver, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are supported as a unit, not apart.
In many parts of America, where a baby is identified with neonatal abstinence syndrome (NAS) regularly, infants are still rushed to special care and treated with pharmaceuticals while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, recovery succeeds, fewer children enter care and long-term costs decline.
It took Stephanie a period to find strength to call, but she finally did. 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 care center, Stephanie still worried that CPS would come remove her daughter – even though she was not sure she wanted to keep her. The anxiety remained: that at any moment, someone could enter and take her baby away.
For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about survival. Substances came first; reliance came last.
Stephanie had one close friend, but even that connection was tenuous. The individuals she cared for always found ways to hurt her. She did not know how to love herself, let alone anyone else.
Every day, staff from Maddie’s Place drove her to a clinic for methadone, given as medication. Gradually, she was embracing sobriety.
She devoted all her time 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 adverse reactions to milk and pronounced gastrointestinal issues. She needed dietary support. She also had sensory challenges and required an professional – all typical problems for babies born with NAS.
When a child recognizes these infants need affection, then I was capable. I could parent.
During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for guided meetings with their babies. A support specialist, a peer support specialist, stopped by with her own children in tow to bring treats. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in awe of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She holds a picture of the moment. She is wearing black pants and a hoodie, a gray knit hat with a decoration on her head, resting on the floor with the exit nearby. She is lean. Her face is downcast so you do not see her expression. She is presenting her daughter on her leg for the children to see and they are gathered around, showing interest to the baby.
One child, eight, asked the moms: “What about the fathers?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if possible.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I could do this. I would become a mother.”
Approaches for managing infants affected by substances have been used for a long time.
The assessment tool was created in 1975|
