A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, the expectant mother arrived at the hospital emergency room after a serious infection started to spread up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had constructed in a companion's property. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had consumed opioids before seeking medical help and had only a brief window to get treated before she had to return to relapse. She thought she still had a month remaining to find a way to become sober and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the doctors would not let her go: the infection in her legs was serious, but medical staff detected she also had an ruptured membrane. The nurse, her nurse, warned her: if she walked out, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be placed on methadone, a medication that eases withdrawal and is often prescribed in addiction recovery.
Five days later, on the 12th of November, Stephanie gave birth to a infant weighing just over four pounds – born before term, tiny yet healthy.
When the nurse asked if she wanted to hold her baby, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been provided shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt awful each time she relapsed. She felt without value, berating herself for not being able to do the impossible. An doctor told her to “just” stop using. Even her supplier would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The common assumption that her love for her baby would make her recover only led to increased guilt and self-harm, a trigger for her to return to drugs. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to medical equipment, so small she thought she would harm her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Medical personnel told her about Maddie’s Place, a new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In much of the US, where a baby is diagnosed with infant withdrawal condition frequently, infants are still whisked to NICUs and given drugs while their mothers face child-protection investigations. But a limited but expanding group of centers like this facility is proving a simple point: when mothers and babies stay together, recovery succeeds, foster placements fall and long-term costs decline.
It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to collect her.
She stepped out of the hospital still in recovery, fearful and unsure about what would happen next.
At the facility, Stephanie still feared that CPS would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any point, someone could walk in and separate them.
For the first two weeks, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about survival. Drugs came first; reliance came last.
Stephanie had a single companion, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She was unable to love herself, much less anyone else.
Daily, staff from the center drove her to a clinic for methadone, administered in pill form. Slowly, she was beginning recovery.
She spent every minute when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed nutritional guidance. She also had heightened sensory issues and required an occupational therapist – all typical problems for babies exposed to substances.
Seeing that even a young person understands the need for care, then I could do this. I could parent.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where individuals struggling with substance use can come for guided meetings with their babies. Katie Bunch-Smith, a peer support specialist, visited with her own family in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She keeps a photo of the moment. She is wearing dark trousers and a sweatshirt, a beanie with a pompom on her head, resting on the floor with the entryway at her back. She is thin. Her face is downcast so you miss her features. She is lifting the baby on her knee for the young ones to see and they are standing close, admiring and touching to the baby.
One child, eight, asked the moms: “Where are all the dads?” The women attempted to clarify that the men were occupied, handling responsibilities, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I would become a mother.”
Methods to address infants affected by substances have existed for decades.
The assessment tool was created in 1975|
