She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
Pregnant and experiencing intense discomfort, a woman named Stephanie went to the hospital emergency room after her infection worsened up her legs. Jobless and without shelter, cut off from her relatives, she stayed in a makeshift shelter she had built in a friend’s yard. She was also hooked on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Withdrawal was setting in. She slumped forward and vomited.
Stephanie finally broke down. “I need to leave. I have to go home and take a hit.”
She had taken the drug before coming to the ER and had only a brief window to get treated before she was compelled to leave to get high again. She thought she still had several weeks to figure out how to get clean and deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was critical, but physicians found she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is often prescribed in rehabilitation.
Five days later, on a day in November 2022, Stephanie gave birth to a baby girl weighing just over four pounds – born before term, tiny yet healthy.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her epidural had failed, her final administration of fentanyl had been given shortly before she gave birth.
She felt ill. Not ready for motherhood. Undeserving.
Stephanie had sought recovery several times during pregnancy, and felt awful each time she was unsuccessful. She felt without value, blaming herself for not being able to overcome the challenge. An doctor told her to “simply” stop using. Even her supplier declined to supply to her when she became clearly expecting.
“However, I failed,” she said. “I had to seek support.”
The common assumption that her love for her baby would make her recover only led to increased guilt and self-abuse, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could will away a long-term illness.
The infant was moved to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to monitors, so small she thought she would hurt her. Embracing her at last, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to name her baby Izzie, after the professional who provided support to her.
Medical personnel told her about Maddie’s Place, a innovative treatment home where women and their babies are treated together, not apart.
In much of the US, where a baby is found to have newborn addiction symptoms regularly, infants are still whisked to NICUs and given drugs while their mothers face custody evaluations. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when mothers and babies stay together, results get better, foster placements fall and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After confirming she would be a good fit for the program, two staff members came to bring her to the facility.
She departed the institution still in detox, fearful and unsure about what would happen next.
At the facility, Stephanie still feared that authorities would come remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could enter and separate them.
For the initial fortnight, Stephanie kept to herself. “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; reliance came last.
Stephanie had one close friend, but even that relationship was delicate. The those close to her always found ways to let her down. She was unable to value herself, much less anyone else.
Each day, staff from the center transported her to a recovery program, provided orally. Gradually, she was starting to get clean.
She devoted all her time when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had increased sensitivity and required an occupational therapist – all common issues for babies affected by withdrawal.
When a child recognizes these infants need affection, then I could do this. I would become a mother.
During a pre-holiday visit, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. Katie Bunch-Smith, a recovery coach, came over with her own family in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in admiration of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is clad in dark trousers and a sweatshirt, a gray knit hat with a pompom on her head, resting on the floor with the exit nearby. She is slender. Her face is downcast so you cannot see her face. She is lifting the baby on her knee for the children to see and they are crowding near, admiring and touching to the baby.
Jacob, eight, asked the mothers: “Why are there no men?” The moms tried to explain that the men were occupied, called away to other tasks, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and Bunch-Smith made eye contact. “I broke down,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I found the courage. I could be a mom.”
Tools for treating drug-exposed newborns have been used for a long time.
The evaluation method was developed in 1975|
