A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Saved Them Both.
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. Without a job or home, estranged from her family, she lived in a shed she had assembled in a acquaintance's garden. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. She leaned over the bed and threw up.
Stephanie ultimately gave in. “I need to leave. I have to go home and get high.”
She had used fentanyl before arriving at the hospital and had sufficient opportunity to get treated before she was compelled to leave to relapse. She thought she still had several weeks to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was critical, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl every few hours, 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 addiction recovery.
After five days, on 12 November 2022, Stephanie had a baby girl weighing a small weight – premature, small but alive.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her pain relief did not work, her last dose of fentanyl had been administered a few hours prior to birth.
She felt sick. Ill-equipped for parenting. Unworthy.
Stephanie had sought recovery several times during pregnancy, and felt horrible each time she relapsed. She felt hopeless, criticizing herself for not being able to overcome the challenge. An doctor told her to “only” stop using. Even her source would not provide to her when she became visibly pregnant.
“However, I failed,” she said. “I needed help.”
The common assumption that her bond with her newborn would make her recover only led to greater shame and self-abuse, a trigger for her to return to drugs. Yet she could not just wish her addiction away, any more than she could eliminate a long-term illness.
The baby was taken to the special care nursery. When Stephanie at last met her, she was connected to medical equipment, so small she thought she would hurt her. Cradling her initially, she felt empty. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
After two days she decided to give her child the name Izzie, after the nurse who had been so kind to her.
Nurses and doctors told her about a specialized facility, a new kind of care center where mothers and their drug-exposed newborns are treated together, not apart.
In many parts of America, where a baby is identified with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like Maddie’s Place is demonstrating a key fact: when mothers and babies stay together, outcomes improve, custody cases decrease and overall savings increase.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After verifying her eligibility for the program, a couple of employees came to pick her up.
She stepped out of the hospital still in detox, anxious and doubtful about what would happen next.
At Maddie’s Place, Stephanie still was concerned that child services would come seize her child – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could arrive and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about survival. Drugs came first; reliance came last.
Stephanie had a single companion, but even that connection was tenuous. The those close to her always found ways to let her down. She was unable to care for herself, not to mention anyone else.
Daily, staff from the facility drove her to a treatment center, administered in pill form. Slowly, she was starting to get clean.
She utilized each moment outside treatment 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 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 found the strength. I would become a mother.
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 mentor, stopped by with her own five kids in tow to drop off cookies. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in awe of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is wearing dark trousers and a sweatshirt, a cap with a decoration on her head, sitting on the wooden floor with the entryway at her back. She is slender. Her face is downcast so you miss her features. She is presenting her daughter on her lap for the children to see and they are crowding near, showing interest to the baby.
A young boy, eight, asked the mothers: “Where are all the dads?” The women attempted to clarify that the fathers had obligations, 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 the specialist exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I could parent.”
Methods to address babies with exposure have been available for years.
The assessment tool was created in 1975|
