A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother visited the hospital emergency room after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she lived in a shed she had assembled in a companion's property. She was also dependent on fentanyl.
As medical staff managed her infection, she started to feel anxious. The onset of withdrawal began. She slumped forward and threw up.
Stephanie eventually collapsed. “I need to leave. I have to go home and get high.”
She had consumed opioids before coming to the ER and had sufficient opportunity to get treated before she was compelled to leave to relapse. She thought she still had four weeks left to plan her recovery and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was severe, but doctors had discovered she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie regulated amounts 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 medication that eases withdrawal and is commonly used in substance abuse treatment.
A short time later, on 12 November 2022, Stephanie had a daughter weighing a small weight – early, small but alive.
When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her anesthesia was ineffective, her final administration of fentanyl had been provided four hours before delivery.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt terrible each time she was unsuccessful. She felt without value, berating herself for not being able to do the impossible. An OBGYN told her to “only” stop using. Even her supplier refused to sell to her when she became clearly expecting.
“Yet I was unable,” she said. “I required assistance.”
The common assumption that her bond with her newborn would make her recover only led to greater shame and self-harm, a impetus for her to use again. Yet she could not simply will her addiction away, any more than she could will away a chronic disease.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was attached to medical equipment, so small she thought she would harm her. Cradling her initially, she felt nothing. “I gazed upon her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
After two days she decided to name her baby the same as her nurse, after the professional who provided support to her.
Medical personnel told her about Maddie’s Place, a innovative treatment home where parents and infants affected by substance use are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with neonatal abstinence syndrome (NAS) regularly, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like this facility is demonstrating a key fact: when mothers and babies stay together, recovery succeeds, custody cases decrease and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After verifying her eligibility for the program, a couple of employees came to collect her.
She stepped out of the hospital still in recovery, anxious and doubtful about what would happen next.
At the facility, Stephanie still worried that CPS would come remove her daughter – even though she was hesitant about parenting. The concern persisted: that at any point, someone could arrive and take her baby away.
For the first two weeks, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Homelessness, she said, was about survival. Addiction came first; trust came last.
Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to hurt her. She did not know how to care for herself, much less anyone else.
Every day, staff from the facility transported her to a recovery program, administered in pill form. Gradually, she was embracing sobriety.
She spent every minute when not in sessions 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 obvious stomach troubles. She needed dietary support. She also had increased sensitivity and required an specialist – all typical problems for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I could do this. I would become a mother.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a mentor, came over with her own five kids in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground 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. They focused only on the baby.”
She keeps a photo of the moment. She is clad in casual attire, a cap with a decoration on her head, resting on the floor with the door behind her. She is thin. Her face is downcast so you cannot see her face. She is presenting her daughter on her lap for the young ones to see and they are crowding near, admiring and touching to the baby.
One child, eight, asked the parents: “What about the fathers?” The moms tried to explain that the men were occupied, engaged elsewhere, that they would be there if they could.
“When I have kids,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and Bunch-Smith exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I found the courage. I would become a mother.”
Tools for treating drug-exposed newborns have been used for a long time.
The assessment tool was created in 1975|
