She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the hospital emergency room after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she stayed in a makeshift shelter she had assembled in a friend’s yard. She was also addicted to fentanyl.
As medical staff managed her infection, she began to panic. The onset of withdrawal began. She leaned over the bed and vomited.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and take a hit.”
She had taken the drug before arriving at the hospital and had just enough time to get treated before she was compelled to leave to relapse. She thought she still had four weeks left to plan her recovery and deliver her child.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was critical, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in substance abuse treatment.
After five days, on a day in November 2022, Stephanie delivered a daughter weighing a small weight – born before term, small but alive.
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 administered four hours before delivery.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt terrible each time she was unsuccessful. She felt without value, berating herself for not being able to do the impossible. An OBGYN told her to “simply” stop using. Even her supplier refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The pervasive expectation that her bond with her newborn would make her recover only led to increased guilt and self-harm, a impetus for her to relapse. Yet she could not just wish her addiction away, any more than she could eliminate a persistent condition.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was hooked up to tubes and leads, so small she thought she would hurt her. Holding her for the first time, she felt detached. “I looked at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to call her daughter the same as her nurse, after the professional who provided support to her.
Medical personnel told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is identified with neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a developing system of centers like Maddie’s Place is showing an important truth: when parents and infants remain united, recovery succeeds, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength to call, but she ultimately reached out. After verifying her eligibility for the program, care providers came to pick her up.
She left the medical center still in withdrawal, anxious and doubtful about what would come next.
At the facility, Stephanie still was concerned that authorities would come seize her child – even though she was not sure she wanted to keep her. The anxiety remained: that at any point, someone could arrive and separate them.
For the first two weeks, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I was suspicious at that point.”
Homelessness, she said, was about survival. Addiction came first; reliance came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She lacked the ability to love herself, not to mention anyone else.
Each day, staff from the facility took her to a clinic for methadone, given as medication. Over time, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed dietary support. She also had increased sensitivity and required an specialist – all frequent conditions for babies exposed to substances.
Seeing that even a young person understands the need for care, then I found the strength. I could be a mom.
One afternoon before Thanksgiving, Stephanie remained in the shared space, 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 crowded near Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in admiration of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a beanie with a pompom on her head, resting on the floor with the door behind her. She is thin. Her face is downcast so you do not see her expression. She is lifting the baby on her lap for the other kids to see and they are crowding near, showing interest to the baby.
One child, eight, asked the moms: “Where are all the dads?” The parents responded that the dads were busy, called away to other tasks, that they would be there if possible.
“In the future,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and Bunch-Smith exchanged glances. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I would become a mother.”
Methods to address drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was established in 1975|
