A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Transformed Their Futures.
In her eighth month of pregnancy and suffering, a woman named Stephanie visited the medical facility after an infection began spreading up her legs. Jobless and without shelter, cut off from her relatives, she resided in a small structure she had constructed 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 slumped forward and threw up.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had just enough time to get treated before she was compelled to leave to use once more. She thought she still had several weeks to plan her recovery and have this baby.
The medical professional intervened. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was severe, but physicians found she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she walked out, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is commonly used in addiction recovery.
After five days, on 12 November 2022, Stephanie gave birth to a infant weighing 4lb 8oz – premature, small but alive.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her epidural had failed, her final administration of fentanyl had been provided a few hours prior to birth.
She felt sick. Not ready for motherhood. Undeserving.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she relapsed. She felt without value, berating herself for not being able to do the impossible. An OBGYN told her to “simply” stop using. Even her dealer would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her bond with her newborn would make her quit only led to increased guilt and negative self-talk, a trigger for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.
The infant was moved to the special care nursery. When Stephanie eventually visited her, she was attached 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 continued to doubt she wanted to be her mother.
Following a brief period she decided to call her daughter Izzie, after the professional who provided support to her.
Nurses and doctors told her about Maddie’s Place, a innovative treatment home where mothers and their drug-exposed newborns are cared for jointly, not apart.
In numerous states, where a baby is diagnosed with infant withdrawal condition every 18 minutes, infants are still whisked to NICUs and medicated while their mothers face child-protection investigations. But a developing system of centers like this facility is proving a simple point: when mothers and babies stay together, 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, 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 worried that CPS would come take Izzie – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could walk in and take her baby away.
For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Addiction came first; trust came last.
Stephanie had a trusted ally, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She lacked the ability to care for herself, let alone anyone else.
Daily, staff from the center transported her to a clinic for methadone, administered in pill form. Gradually, she was beginning recovery.
She spent every minute outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an professional – all common issues for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. A support specialist, a peer support specialist, visited with her own family in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is wearing casual attire, a beanie with a pompom on her head, resting on the floor with the exit nearby. She is lean. Her posture is humble so you cannot see her face. She is lifting the baby on her knee for the children to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the moms: “Where are all the dads?” The parents responded that the fathers had obligations, handling responsibilities, that they would be there given the chance.
“In the future,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith made eye contact. “I broke down,” Stephanie said. “When a child recognized that infants need affection, then I was able. I could be a mom.”
Methods to address babies with exposure have existed for decades.
The assessment tool was established in 1975|