Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
Eight months pregnant and in severe pain, a woman named Stephanie 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 built in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She bent over the bedside and vomited.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and get high.”
She had used fentanyl before coming to the ER and had just enough time to get treated before she had to return to relapse. She thought she still had four weeks left to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the infection in her legs was critical, 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.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be placed on methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.
After five days, on a day in November 2022, Stephanie delivered a daughter weighing a small weight – early, small but alive.
When the attendant inquired if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her pain relief did not work, her final administration of fentanyl had been administered a few hours prior to birth.
She felt unwell. Unprepared to be a mother. Undeserving.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she failed. She felt hopeless, criticizing herself for not being able to do the impossible. An doctor told her to “only” stop using. Even her source would not provide to her when she became visibly pregnant.
“However, I failed,” she said. “I required assistance.”
The widespread belief that her love for her baby would make her quit only led to deeper self-loathing and self-harm, a cause for her to relapse. Yet she could not simply will 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 finally saw her her, she was connected to medical equipment, so tiny she thought she would break her. Embracing her at last, she felt nothing. “I just stared at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to name her baby Izzie, after the nurse who had been so kind to her.
Nurses and doctors told her about Maddie’s Place, a new kind of care center where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is found to have infant withdrawal condition regularly, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a developing system of centers like this facility is proving a simple point: when parents and infants remain united, recovery succeeds, custody cases decrease and overall savings increase.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After ensuring she qualified for the program, a couple of employees came to pick her up.
She departed the institution still in detox, scared and uncertain about what would follow.
At Maddie’s Place, Stephanie still feared that CPS would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could walk in and separate them.
For the initial fortnight, Stephanie kept to herself. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about survival. Substances came first; reliance came last.
Stephanie had a trusted ally, but even that connection was tenuous. The people she loved always found ways to cause pain. She did not know how to value herself, not to mention anyone else.
Daily, staff from the center took her to a recovery program, provided orally. Over time, she was embracing sobriety.
She utilized each moment 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 sensitivity to certain foods and severe digestive problems. She needed nutritional guidance. She also had sensory challenges and required an occupational therapist – all typical problems for babies born with NAS.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. Katie Bunch-Smith, a recovery coach, stopped by with her own children in tow to drop off cookies. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in wonder of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She keeps a photo of the moment. She is wearing casual attire, a cap with a decoration on her head, resting on the floor with the exit nearby. She is lean. Her face is downcast so you miss her features. She is presenting her daughter on her lap for the other kids to see and they are gathered around, showing interest to the baby.
Jacob, eight, asked the parents: “Where are all the dads?” The women attempted to clarify that the men were occupied, engaged elsewhere, that they would be there if they could.
“In the future,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I could do this. I could parent.”
Tools for treating drug-exposed newborns have existed for decades.
The assessment tool was developed in 1975|
