She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
In her eighth month of pregnancy and suffering, a woman named Stephanie visited the medical facility after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she stayed in a makeshift shelter she had constructed in a companion's property. She was also dependent on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and became sick.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and take a hit.”
She had taken the drug before seeking medical help and had only a brief window to get treated before she needed to go home to use once more. She thought she still had several weeks to find a way to become sober and give birth.
The medical professional intervened. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
A short time later, on 12 November 2022, Stephanie gave birth to a infant weighing just over four pounds – premature, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was numb. Her pain relief did not work, her last dose of fentanyl had been administered a few hours prior to birth.
She felt ill. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she failed. She felt hopeless, criticizing herself for not being able to achieve the unattainable. An doctor told her to “just” stop using. Even her supplier refused to sell to her when she became visibly pregnant.
“Yet I was unable,” she said. “I required assistance.”
The widespread belief that her affection for her child would make her stop using only led to increased guilt and self-abuse, a cause for her to relapse. Yet she could not just wish her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the neonatal intensive care unit. When Stephanie at last met her, she was attached to tubes and leads, so small she thought she would hurt her. Holding her for the first time, she felt empty. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period 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 unique recovery environment where women and their babies are supported as a unit, not apart.
In many parts of America, where a baby is identified with infant withdrawal condition every 18 minutes, infants are still rushed to special care and treated with pharmaceuticals while their mothers face child-protection investigations. But a developing system of centers like this facility is proving a simple point: when families are kept intact, recovery succeeds, fewer children enter care and overall savings increase.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After ensuring she qualified for the program, two staff members came to collect her.
She departed the institution still in recovery, anxious and doubtful about what would come 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 fear lingered: that at any point, someone could walk in and separate them.
For the first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about getting by. Drugs came first; trust came last.
Stephanie had a trusted ally, but even that connection was tenuous. The those close to her always found ways to let her down. She did not know how to value herself, not to mention anyone else.
Every day, staff from the facility transported her to a recovery program, administered in pill form. Gradually, she was starting to get clean.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had sensory challenges and required an professional – all frequent conditions for babies exposed to substances.
Seeing that even a young person understands the need for care, then I was capable. I would become a mother.
During a pre-holiday visit, Stephanie was in the common room, where parents in active addiction can come for supervised visits with their babies. Katie Bunch-Smith, a mentor, visited with her own children in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in admiration of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She has an image of the moment. She is clad in black pants and a hoodie, a cap with a decoration on her head, resting on the floor with the door behind her. She is lean. Her posture is humble so you do not see her expression. She is lifting the baby on her lap for the young ones to see and they are gathered around, showing interest to the baby.
One child, eight, asked the mothers: “Where are all the dads?” The parents responded that the men were occupied, called away to other tasks, that they would be there given the chance.
“In the future,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I could do this. I could be a mom.”
Approaches for managing infants affected by substances have existed for decades.
The evaluation method was developed in 1975|