She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
Eight months pregnant and in severe pain, the expectant mother went to the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, cut off from her relatives, she lived in a shed she had built in a companion's property. She was also hooked on fentanyl.
As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She slumped forward and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and take a hit.”
She had consumed opioids before arriving at the hospital and had only a brief window to get treated before she was compelled to leave to use once more. She thought she still had four weeks left to plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but physicians found she also had an ruptured membrane. The nurse, Izzie, warned her: if she walked out, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be switched to methadone, a medication that eases withdrawal and is often prescribed in rehabilitation.
After five days, on 12 November 2022, Stephanie gave birth to a infant weighing 4lb 8oz – early, tiny yet healthy.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her epidural had failed, her final administration of fentanyl had been administered a few hours prior to birth.
She felt ill. Unprepared to be a mother. Undeserving.
Stephanie had sought recovery repeatedly before birth, and felt terrible each time she relapsed. She felt hopeless, blaming herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her dealer declined to supply to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her stop using 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 overcome a chronic disease.
The newborn was transferred to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to monitors, so small she thought she would break her. Holding her for the first time, she felt detached. “I just stared at 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 call her daughter the same as her nurse, after the attendant who showed compassion to her.
Nurses and doctors told her about Maddie’s Place, a innovative treatment home where women and their babies are supported as a unit, not apart.
In many parts of America, where a baby is diagnosed with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a developing system of centers like this facility is proving a simple point: when parents and infants remain united, results get better, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength to call, but she ultimately reached out. After confirming she would be a good fit for the program, care providers came to collect her.
She stepped out of the hospital still in recovery, anxious and doubtful about what would come next.
At the care center, Stephanie still worried that authorities would come take Izzie – even though she was not sure she wanted to keep her. The fear lingered: that at any point, someone could arrive and separate them.
For the first two weeks, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about survival. Addiction came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to let her down. She did not know how to care for herself, let alone anyone else.
Every day, staff from the facility transported her to a clinic for methadone, provided orally. Slowly, she was starting to get clean.
She spent every minute when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and obvious stomach troubles. She needed nutritional guidance. She also had sensory challenges and required an specialist – all frequent conditions for babies exposed to substances.
When a child recognizes these infants need affection, then I could do this. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where individuals struggling with substance use can come for monitored interactions with their babies. An advocate, a mentor, came over with her own family in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in admiration of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is dressed in casual attire, a cap with a bobble on her head, sitting on the wooden floor with the door behind her. She is thin. Her posture is humble so you miss her features. She is lifting the baby on her leg for the young ones to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the mothers: “Where are all the dads?” The women attempted to clarify that the dads were busy, handling responsibilities, that they would be there if they could.
“Once I become a parent,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I was able. I could be a mom.”
Approaches for managing infants affected by substances have been used for a long time.
The Finnegan NAS scale was created in 1975|