She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, a woman named Stephanie went to the ER after her infection worsened up her legs. Unemployed and homeless, separated from loved ones, she stayed in a makeshift shelter she had built in a companion's property. She was also hooked on fentanyl.
As doctors treated her infection, she started to feel anxious. The onset of withdrawal began. She slumped forward and vomited.
Stephanie finally broke down. “I have to get out of here. I have to go home and take a hit.”
She had taken the drug before coming to the ER and had only a brief window to get treated before she was compelled to leave to relapse. She thought she still had four weeks left to plan her recovery and have this baby.
The nurse had other ideas. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was severe, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she walked out, 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. Once the baby was born Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.
Five days later, on a day in November 2022, Stephanie had a infant weighing 4lb 8oz – early, little but surviving.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her final administration of fentanyl had been provided four hours before delivery.
She felt unwell. Not ready for motherhood. Undeserving.
Stephanie had attempted sobriety several times during pregnancy, and felt terrible each time she failed. She felt worthless, criticizing herself for not being able to achieve the unattainable. An obstetrician told her to “only” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her love for her baby would make her recover only led to deeper self-loathing and self-abuse, a trigger for her to return to drugs. Yet she could not easily command her addiction away, any more than she could eliminate a long-term illness.
The infant was moved to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to tubes and leads, so tiny she thought she would harm her. Holding her for the first time, she felt empty. “I gazed upon her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about a specialized facility, a new kind of care center where mothers and their drug-exposed newborns are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition regularly, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a limited but expanding group of centers like Maddie’s Place is demonstrating a key fact: when parents and infants remain united, outcomes improve, fewer children enter care and overall savings increase.
It took Stephanie a while to gather the courage to call, but she finally did. After verifying her eligibility for the program, care providers came to collect her.
She left the medical center still in recovery, anxious and doubtful about what would follow.
At the facility, Stephanie still feared that authorities would come seize her child – even though she was hesitant about parenting. The concern persisted: that at any moment, someone could walk in and take her baby away.
For the first two weeks, Stephanie kept to herself. “I avoided interaction,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Substances came first; faith came last.
Stephanie had a trusted ally, but even that relationship was delicate. The people she loved always found ways to cause pain. She did not know how to value herself, not to mention anyone else.
Every day, staff from Maddie’s Place took her to a recovery program, administered in pill form. Over time, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and obvious stomach troubles. 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 was capable. I could parent.
On a day prior to the holiday, Stephanie sat in the visitation area, where individuals struggling with substance use can come for guided meetings with their babies. Katie Bunch-Smith, a recovery coach, stopped by with her own children in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She keeps a photo of the moment. She is clad in black pants and a hoodie, a beanie with a bobble on her head, sitting on the wooden floor with the exit nearby. She is thin. Her head is tilted forward so you cannot see her face. She is lifting the baby on her leg for the children to see and they are crowding near, showing interest to the baby.
A young boy, eight, asked the parents: “Where are all the dads?” The parents responded that the men were occupied, handling responsibilities, that they would be there if possible.
“In the future,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and the specialist made eye contact. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I could parent.”
Methods to address babies with exposure have been available for years.
The assessment tool was created in 1975|
