She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
Eight months pregnant and in severe pain, the expectant mother visited the medical facility after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she lived in a shed she had assembled in a companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and threw up.
Stephanie finally broke down. “I have to get out of here. I have to go home and take a hit.”
She had taken the drug before arriving at the hospital and had sufficient opportunity to get treated before she needed to go home to use once more. She thought she still had several weeks to plan her recovery and give birth.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was severe, but medical staff detected she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she left, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.
A short time later, on 12 November 2022, Stephanie had a daughter weighing a small weight – born before term, tiny yet healthy.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her pain relief did not work, her final administration of fentanyl had been provided a few hours prior to birth.
She felt sick. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety several times during pregnancy, and felt horrible each time she was unsuccessful. She felt hopeless, criticizing herself for not being able to achieve the unattainable. An doctor told her to “just” stop using. Even her supplier would not provide to her when she became obviously with child.
“Yet I was unable,” she said. “I needed help.”
The common assumption that her bond with her newborn would make her quit only led to increased guilt and self-harm, a trigger for her to use again. Yet she could not just wish her addiction away, any more than she could will away a long-term illness.
The newborn was transferred to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to tubes and leads, so small she thought she would hurt her. Embracing her at last, she felt detached. “I looked at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the nurse who had been so kind to her.
Hospital staff told her about Maddie’s Place, a unique recovery environment where parents and infants affected by substance use are supported as a unit, not apart.
In many parts of America, where a baby is identified with infant withdrawal condition frequently, infants are still whisked to NICUs and medicated while their mothers face child-protection investigations. But a developing system of centers like the care home is showing an important truth: when parents and infants remain united, results get better, custody cases decrease 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 collect her.
She departed the institution still in detox, scared and uncertain about what would happen next.
At the care center, Stephanie still feared that CPS would come take Izzie – even though she was not sure she wanted to keep her. The concern persisted: that at any moment, someone could arrive and separate them.
For the beginning period, Stephanie remained isolated. “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 enduring. Addiction came first; reliance came last.
Stephanie had a trusted ally, but even that bond was fragile. The those close to her always found ways to cause pain. She did not know how to value herself, much less anyone else.
Every day, staff from the facility drove her to a clinic for methadone, administered in pill form. Slowly, she was embracing sobriety.
She devoted all her time outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed feeding therapy. She also had increased sensitivity and required an occupational therapist – all typical problems for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I was capable. I could be a mom.
On a day prior to the holiday, Stephanie remained in the shared space, where parents in active addiction can come for monitored interactions with their babies. A support specialist, a peer support specialist, visited with her own five kids in tow to deliver baked goods. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed 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 has an image of the moment. She is wearing dark trousers and a sweatshirt, a beanie with a decoration on her head, resting on the floor with the entryway at her back. She is slender. Her head is tilted forward so you do not see her expression. She is presenting her daughter on her lap for the other kids to see and they are gathered around, showing interest to the baby.
A young boy, eight, asked the parents: “Where are all the dads?” The parents responded that the dads were busy, handling responsibilities, that they would be there given the chance.
“When I have kids,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I could do this. I would become a mother.”
Tools for treating drug-exposed newborns have existed for decades.
The assessment tool was developed in 1975|
