She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie visited the ER after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had constructed in a friend’s yard. She was also hooked on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Withdrawal was setting in. She bent over the bedside and threw up.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and get high.”
She had used fentanyl before seeking medical help 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 deliver her child.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the leg infection was severe, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be placed on methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.
Five days later, on 12 November 2022, Stephanie had a daughter weighing a small weight – premature, little but surviving.
When the attendant inquired if she wanted to embrace her child, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her last dose of fentanyl had been provided four hours before delivery.
She felt unwell. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety repeatedly before birth, and felt awful each time she relapsed. She felt worthless, berating herself for not being able to overcome the challenge. An obstetrician told her to “just” stop using. Even her source refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The pervasive expectation that her affection for her child would make her quit only led to deeper self-loathing and self-harm, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The newborn was transferred to the neonatal intensive care unit. When Stephanie finally saw her her, she was attached to medical equipment, so little she thought she would break her. Cradling her initially, she felt nothing. “I gazed upon her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Two days later she decided to name her baby after her caregiver, after the nurse who had been so kind to her.
Hospital staff told her about Maddie’s Place, a innovative treatment home where women and their babies are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still whisked to NICUs and medicated while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is showing an important truth: when mothers and babies stay together, recovery succeeds, fewer children enter care and overall savings increase.
It took Stephanie some time to build confidence to call, but she finally did. After verifying her eligibility for the program, two staff members came to pick her up.
She stepped out of the hospital still in recovery, scared and uncertain about what would happen next.
At Maddie’s Place, Stephanie still was concerned that CPS would come take Izzie – even though she was not sure she wanted to keep her. The anxiety remained: that at any moment, someone could enter and separate them.
For the first two weeks, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about survival. Drugs came first; faith 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 lacked the ability to love herself, much less anyone else.
Daily, staff from Maddie’s Place transported her to a recovery program, given as medication. Slowly, she was beginning recovery.
She utilized each moment outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed feeding therapy. She also had increased sensitivity and required an occupational therapist – all common issues for babies born with NAS.
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 sat in the visitation area, where individuals struggling with substance use can come for monitored interactions with their babies. A support specialist, a recovery coach, came over with her own five kids in tow to deliver baked goods. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The kids looked amazed in wonder of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is dressed in black pants and a hoodie, a beanie with a bobble on her head, resting on the floor with the exit nearby. She is slender. Her face is downcast so you miss her features. She is holding Izzie up on her lap for the children to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the mothers: “Why are there no men?” The parents responded that the men were occupied, handling responsibilities, that they would be there if they could.
“In the future,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith made eye contact. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I was able. I would become a mother.”
Approaches for managing drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was created in 1975|
