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 visited the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had assembled in a friend’s yard. She was also hooked on fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She bent over the bedside and threw up.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had used fentanyl 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 find a way to become sober and give birth.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was critical, but physicians found she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be placed on methadone, a medication that eases withdrawal and is commonly used in addiction recovery.
Five days later, on a day in November 2022, Stephanie had a infant weighing 4lb 8oz – born before term, small but alive.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her anesthesia was ineffective, her final administration of fentanyl had been provided a few hours prior to birth.
She felt ill. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety several times during pregnancy, and felt horrible each time she was unsuccessful. She felt without value, berating herself for not being able to achieve the unattainable. An obstetrician told her to “just” stop using. Even her dealer would not provide to her when she became clearly expecting.
“Yet I was unable,” she said. “I had to seek support.”
The common assumption that her bond with her newborn would make her quit only led to increased guilt and self-abuse, a cause for her to return to drugs. Yet she could not simply will her addiction away, any more than she could eliminate a chronic disease.
The newborn was transferred to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to monitors, so small she thought she would break her. Embracing her at last, she felt nothing. “I looked at 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 after her caregiver, after the attendant who showed compassion to her.
Medical personnel told her about Maddie’s Place, a new kind of care center where mothers and their drug-exposed newborns are treated together, not apart.
In many parts of America, where a baby is found to have infant withdrawal condition frequently, infants are still rushed to special care and given drugs while their mothers face parental assessments. But a small, growing network of centers like the care home is showing an important truth: when parents and infants remain united, recovery succeeds, custody cases decrease and overall savings increase.
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, care providers came to bring her to the facility.
She stepped out of the hospital still in withdrawal, scared and uncertain about what would follow.
At the facility, Stephanie still feared that CPS would come remove her daughter – even though she was not sure she wanted to keep her. The anxiety remained: that at any point, someone could walk in and take her baby away.
For the first two weeks, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about enduring. Substances 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 let her down. She was unable to care for herself, let alone anyone else.
Each day, staff from the center transported her to a clinic for methadone, provided orally. Over time, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed dietary support. She also had sensory challenges and required an specialist – all frequent conditions for babies exposed to substances.
Seeing that even a young person understands the need for care, then I found the strength. I could parent.
During a pre-holiday visit, Stephanie sat in the visitation area, where those still using can come for monitored interactions with their babies. A support specialist, a mentor, came over with her own family in tow to drop off cookies. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in awe of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She keeps a photo of the moment. She is clad in black pants and a hoodie, a cap with a pompom on her head, seated on the ground with the door behind her. She is slender. Her head is tilted forward so you do not see her expression. She is presenting her daughter on her knee for the children to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the moms: “Where are all the dads?” 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. They will know they are valued.”
Stephanie and the specialist looked at each other. “I became emotional,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.”
Approaches for managing drug-exposed newborns have been available for years.
The Finnegan NAS scale was created in 1975|
