She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
Eight months pregnant and in severe pain, a woman named Stephanie went to the medical facility after her infection worsened up her legs. Jobless and without shelter, estranged from her family, she lived in a shed she had built in a companion's property. She was also dependent on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. The onset of withdrawal began. She slumped forward and became sick.
Stephanie finally broke down. “I have to get out of here. I have to go home and take a hit.”
She had used fentanyl before arriving at the hospital and had just enough time to get treated before she needed to go home to use once more. She thought she still had four weeks left to find a way to become sober and deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the medical facility declined to release her: the leg infection was serious, but physicians found she also had an ruptured membrane. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.
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 switched to methadone, a drug that alleviates cravings and is commonly used in addiction recovery.
A short time later, on 12 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 “no.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been provided shortly before she gave birth.
She felt ill. Not ready for motherhood. Unworthy.
Stephanie had sought recovery repeatedly before birth, and felt terrible each time she relapsed. She felt worthless, berating herself for not being able to overcome the challenge. An OBGYN told her to “simply” stop using. Even her source refused to sell to her when she became visibly pregnant.
“Yet I was unable,” she said. “I required assistance.”
The pervasive expectation that her bond with her newborn would make her quit only led to deeper self-loathing and self-harm, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the NICU. When Stephanie finally saw her her, she was connected to medical equipment, so little she thought she would harm her. Embracing her at last, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to give her child the name the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a innovative treatment home where parents and infants affected by substance use are supported as a unit, not apart.
In much of the US, where a baby is diagnosed with neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face child-protection investigations. But a small, growing network of centers like this facility is proving a simple point: when families are kept intact, outcomes improve, foster placements fall and long-term costs decline.
It took Stephanie a period to find strength to call, but she eventually made the call. After confirming she would be a good fit for the program, two staff members came to pick her up.
She departed the institution still in recovery, fearful and unsure about what would happen next.
At the care center, Stephanie still worried that child services would come take Izzie – even though she was uncertain about motherhood. The concern persisted: that at any point, someone could walk in and remove her child.
For the initial fortnight, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Life on the streets, she said, was about getting by. 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 hurt her. She did not know how to care for herself, much less anyone else.
Daily, staff from the center transported her to a treatment center, provided orally. Slowly, she was starting to get clean.
She spent every minute 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 nutritional guidance. She also had heightened sensory issues and required an professional – all frequent conditions for babies affected by withdrawal.
When a child recognizes these infants need affection, then I was capable. I could parent.
During a pre-holiday visit, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own family in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The young ones stared in wonder of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She holds a picture of the moment. She is clad in black pants and a hoodie, a gray knit hat with a decoration on her head, seated on the ground with the exit nearby. She is thin. Her posture is humble so you miss her features. She is presenting her daughter on her lap for the young ones to see and they are crowding near, admiring and touching to the baby.
Jacob, eight, asked the mothers: “What about the fathers?” The women attempted to clarify that the fathers had obligations, handling responsibilities, that they would be there given the chance.
“In the future,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and her companion made eye contact. “I broke down,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I could be a mom.”
Methods to address drug-exposed newborns have been available for years.
The evaluation method was developed in 1975|
