She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie visited the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, cut off from her relatives, she stayed in a makeshift shelter she had assembled in a acquaintance's garden. She was also hooked on fentanyl.
As medical staff managed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and vomited.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had consumed opioids before seeking medical help and had just enough time to get treated before she had to return to use once more. She thought she still had four weeks left to find a way to become sober and give birth.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the infection in her legs was severe, but physicians found she also had an ruptured membrane. The nurse, her nurse, warned her: if she left, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
A short time later, on a day in November 2022, Stephanie delivered a infant weighing a small weight – early, little but surviving.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been provided a few hours prior to birth.
She felt ill. Unprepared to be a mother. Not fit.
Stephanie had attempted sobriety several times during pregnancy, and felt awful each time she relapsed. She felt hopeless, criticizing herself for not being able to do the impossible. An doctor told her to “just” stop using. Even her supplier would not provide to her when she became obviously with child.
“However, I failed,” she said. “I needed help.”
The widespread belief that her affection for her child would make her stop using only led to increased guilt and negative self-talk, 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 tubes and leads, so tiny she thought she would break her. Holding her for the first time, she felt detached. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the attendant who showed compassion to her.
Medical personnel told her about Maddie’s Place, a new kind of care center where women and their babies are supported as a unit, not apart.
In numerous states, where a baby is found to have neonatal abstinence syndrome (NAS) every 18 minutes, infants are still whisked to NICUs and medicated while their mothers face custody evaluations. But a small, growing network of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, recovery succeeds, foster placements fall and future expenses reduce.
It took Stephanie a period to find strength to call, but she eventually made the call. After ensuring she qualified for the program, a couple of employees came to pick her up.
She left the medical center still in detox, fearful and unsure about what would come next.
At the facility, Stephanie still feared that CPS would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any point, someone could enter and separate them.
For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about enduring. Substances came first; reliance came last.
Stephanie had a trusted ally, but even that bond was fragile. The individuals she cared for always found ways to let her down. She was unable to value herself, let alone anyone else.
Every day, staff from the center took her to a recovery program, administered in pill form. Gradually, she was beginning recovery.
She devoted all her time beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an professional – all typical problems for babies exposed to substances.
When a child recognizes these infants need affection, then I could do this. I could be a mom.
During a pre-holiday visit, Stephanie was in the common room, where parents in active addiction can come for guided meetings with their babies. A support specialist, a recovery coach, came over 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 admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She has an image of the moment. She is wearing dark trousers and a sweatshirt, a beanie with a decoration on her head, sitting on the wooden floor with the entryway at her back. She is lean. Her head is tilted forward so you miss her features. She is lifting the baby on her leg for the young ones to see and they are crowding near, fawning and reaching out to the baby.
A young boy, eight, asked the parents: “What about the fathers?” The parents responded that the fathers had obligations, 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 the specialist exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that newborns require care, then I was able. I would become a mother.”
Tools for treating babies with exposure have been used for a long time.
The assessment tool was established in 1975|