She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
In her eighth month of pregnancy and suffering, a woman named Stephanie arrived at the medical facility after a serious infection started to spread up her legs. Jobless and without shelter, cut off from her relatives, 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 grew increasingly fearful. Withdrawal was setting in. She leaned over the bed and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and get high.”
She had consumed opioids before coming to the ER and had just enough time to get treated before she had to return to use once more. She thought she still had several weeks to figure out how to get clean and deliver her child.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is commonly used in rehabilitation.
A short time later, on 12 November 2022, Stephanie gave birth to a infant weighing a small weight – premature, small but alive.
When the nurse asked if she wanted to embrace her child, Stephanie said “no.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been administered four hours before delivery.
She felt sick. Not ready for motherhood. Not fit.
Stephanie had tried to get clean several times during pregnancy, and felt terrible each time she was unsuccessful. She felt worthless, criticizing herself for not being able to overcome the challenge. An OBGYN told her to “simply” stop using. Even her supplier would not provide to her when she became clearly expecting.
“Yet I was unable,” she said. “I needed help.”
The common assumption that her affection for her child would make her stop using only led to greater shame and negative self-talk, a impetus for her to relapse. 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 NICU. When Stephanie at last met her, she was hooked up to monitors, so little she thought she would break her. Embracing her at last, she felt empty. “I looked at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
After two days she decided to give her child the name the same as her nurse, after the professional who provided support to her.
Nurses and doctors told her about Maddie’s Place, a innovative treatment home where women and their babies are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with infant withdrawal condition regularly, infants are still whisked to NICUs and given drugs while their mothers face parental assessments. But a limited but expanding group of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, results get better, fewer children enter care and long-term costs decline.
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 bring her to the facility.
She stepped out of the hospital still in withdrawal, fearful and unsure about what would come next.
At the care center, Stephanie still worried that CPS would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could enter and remove her child.
For the beginning period, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Homelessness, she said, was about survival. Drugs came first; faith came last.
Stephanie had a trusted ally, but even that connection was tenuous. The those close to her always found ways to hurt her. She was unable to care for herself, let alone anyone else.
Daily, staff from Maddie’s Place transported her to a clinic for methadone, provided orally. Slowly, she was starting to get clean.
She devoted all her time beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an specialist – all common issues for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I found the strength. I could parent.
On a day prior to the holiday, Stephanie remained in the shared space, where parents in active addiction can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, visited with her own five kids in tow to deliver baked goods. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in wonder of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She holds a picture of the moment. She is clad in black pants and a hoodie, a cap with a decoration on her head, seated on the ground with the exit nearby. She is thin. Her posture is humble so you cannot see her face. She is lifting the baby on her lap for the young ones to see and they are crowding near, fawning and reaching out to the baby.
Jacob, eight, asked the mothers: “Where are all the dads?” The parents responded that the dads were busy, called away to other tasks, that they would be there given the chance.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and her companion made eye contact. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I could do this. I would become a mother.”
Approaches for managing drug-exposed newborns have been used for a long time.
The assessment tool was developed in 1975|
