She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother visited the ER after a serious infection started to spread up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had constructed in a companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she started to feel anxious. The onset of withdrawal began. She bent over the bedside 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 coming to the ER and had sufficient opportunity to get treated before she had to return to get high again. She thought she still had a month remaining to figure out how to get clean and have this baby.
The attending nurse disagreed. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.
A short time later, on a day in November 2022, Stephanie gave birth to a infant weighing just over four pounds – premature, small but alive.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her pain relief did not work, her last dose of fentanyl had been provided a few hours prior to birth.
She felt ill. Unprepared to be a mother. Undeserving.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she was unsuccessful. She felt without value, berating herself for not being able to do the impossible. An obstetrician told her to “simply” stop using. Even her supplier would not provide to her when she became visibly pregnant.
“Yet I was unable,” she said. “I needed help.”
The common assumption that her bond with her newborn would make her recover only led to increased guilt and self-harm, a cause for her to return to drugs. Yet she could not simply will her addiction away, any more than she could eliminate a long-term illness.
The baby was taken to the special care nursery. When Stephanie eventually visited her, she was connected to medical equipment, so small she thought she would break her. Holding her for the first time, 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.
Two days later she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a unique recovery environment 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 rushed to special care and treated with pharmaceuticals while their mothers face custody evaluations. But a small, growing network of centers like the care home is demonstrating a key fact: when parents and infants remain united, outcomes improve, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to bring her to the facility.
She departed the institution still in withdrawal, anxious and doubtful about what would follow.
At Maddie’s Place, Stephanie still feared that authorities would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could arrive and remove her child.
For the initial fortnight, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about getting by. Drugs came first; reliance came last.
Stephanie had a trusted ally, but even that relationship was delicate. The people she loved always found ways to hurt her. She was unable to value herself, much less anyone else.
Daily, staff from Maddie’s Place transported her to a treatment center, provided orally. Over time, she was beginning recovery.
She devoted all her time beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and severe digestive problems. She needed feeding therapy. She also had heightened sensory issues 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 could be a mom.
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. Katie Bunch-Smith, a mentor, came over with her own five kids in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in admiration of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She has an image of the moment. She is wearing casual attire, a gray knit hat 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 cannot see her face. She is holding Izzie up on her leg for the other kids to see and they are crowding near, showing interest to the baby.
Jacob, eight, asked the moms: “What about the fathers?” The women attempted to clarify that the fathers had obligations, engaged elsewhere, that they would be there if they could.
“When I have kids,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist looked at each other. “I broke down,” Stephanie said. “When a child recognized that infants need affection, then I was able. I could be a mom.”
Methods to address babies with exposure have existed for decades.
The assessment tool was developed in 1975|
