She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
Eight months pregnant and in severe pain, a woman named Stephanie arrived at the medical facility after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had assembled in a acquaintance's garden. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and threw up.
Stephanie eventually collapsed. “I need to leave. I have to go home and use drugs.”
She had consumed opioids before coming to the ER and had just enough time to get treated before she had to return to relapse. She thought she still had a month remaining to plan her recovery and have this baby.
The attending nurse disagreed. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be placed on methadone, a treatment that reduces symptoms and is frequently utilized in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie gave birth to a daughter weighing a small weight – born before term, little but surviving.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “I cannot.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been given a few hours prior to birth.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean several times during pregnancy, and felt terrible each time she failed. She felt without value, berating herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her dealer would not provide to her when she became clearly expecting.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her affection for her child would make her recover only led to deeper self-loathing and negative self-talk, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could will away a long-term illness.
The infant was moved to the NICU. When Stephanie at last met her, she was connected to tubes and leads, so tiny she thought she would break her. Cradling her initially, she felt detached. “I looked at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to call her daughter after her caregiver, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a unique recovery environment where women and their babies are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a developing system of centers like Maddie’s Place is proving a simple point: when families are kept intact, recovery succeeds, fewer children enter care and overall savings increase.
It took Stephanie some time to build confidence to call, but she eventually made the call. After verifying her eligibility for the program, a couple of employees came to pick her up.
She left the medical center still in detox, anxious and doubtful about what would happen next.
At the facility, Stephanie still feared that CPS would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any moment, someone could arrive and separate them.
For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about getting by. Substances came first; faith came last.
Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to cause pain. She was unable to care for herself, let alone anyone else.
Each day, staff from the center drove her to a clinic for methadone, administered in pill form. Over time, she was beginning recovery.
She devoted all her time outside treatment 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 nutritional guidance. She also had sensory challenges and required an specialist – 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 be a mom.
During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. An advocate, a recovery coach, stopped by with her own five kids in tow to deliver baked goods. They all assembled beside 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. They focused only on the baby.”
She holds a picture 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 thin. Her face is downcast so you miss her features. She is lifting the baby on her lap for the children to see and they are gathered around, fawning and reaching out to the baby.
One child, eight, asked the parents: “Where are all the dads?” The parents responded that the fathers had obligations, called away to other tasks, that they would be there if possible.
“When I have kids,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and Bunch-Smith exchanged glances. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that newborns require care, then I could do this. I could be a mom.”
Tools for treating babies with exposure have been used for a long time.
The evaluation method was created in 1975|
