A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
Pregnant and experiencing intense discomfort, a woman named Stephanie went to the medical facility after an infection began spreading up her legs. Jobless and without shelter, estranged from her family, she resided in a small structure she had assembled in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. The onset of withdrawal began. She bent over the bedside and threw up.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and take a hit.”
She had consumed opioids before seeking medical help and had only a brief window to get treated before she was compelled to leave to get high again. She thought she still had several weeks to figure out how to get clean and give birth.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but physicians found she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she departed, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be transitioned to methadone, a medication that eases withdrawal and is often prescribed in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie had a daughter weighing 4lb 8oz – premature, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been provided shortly before she gave birth.
She felt ill. Ill-equipped for parenting. Undeserving.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she relapsed. She felt hopeless, blaming herself for not being able to do the impossible. An OBGYN told her to “simply” stop using. Even her supplier would not provide to her when she became clearly expecting.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her affection for her child would make her stop using only led to deeper self-loathing and self-harm, a cause for her to relapse. Yet she could not easily command her addiction away, any more than she could will away a chronic disease.
The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was hooked up to medical equipment, so tiny she thought she would break her. Embracing her at last, she felt nothing. “I looked at her and was like, ‘What is our future?’” She remained uncertain 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.
Hospital staff told her about Maddie’s Place, a new kind of care center where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is found to have infant withdrawal condition every 18 minutes, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a limited but expanding group of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, recovery succeeds, foster placements fall and future expenses reduce.
It took Stephanie a period to find strength to call, but she finally did. After confirming she would be a good fit for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in withdrawal, anxious and doubtful about what would come next.
At the facility, Stephanie still was concerned that child services would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any point, someone could walk in and take her baby away.
For the initial fortnight, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about enduring. Substances came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to let her down. She lacked the ability to value herself, let alone anyone else.
Every day, staff from Maddie’s Place took her to a clinic for methadone, provided orally. Gradually, she was beginning recovery.
She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and severe digestive problems. She needed feeding therapy. She also had heightened sensory issues and required an occupational therapist – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I was capable. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for guided meetings with their babies. A support specialist, a mentor, came over with her own family in tow to deliver baked goods. They all gathered around Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in wonder of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a bobble on her head, seated on the ground with the exit nearby. She is slender. Her posture is humble so you cannot see her face. She is lifting the baby on her knee for the children to see and they are gathered around, showing interest to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The moms tried to explain that the dads were busy, handling responsibilities, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I was able. I could be a mom.”
Methods to address infants affected by substances have existed for decades.
The Finnegan NAS scale was created in 1975|