She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, a woman named Stephanie went to the hospital emergency room after a serious infection started to spread up her legs. Jobless and without shelter, estranged from her family, she lived in a shed she had assembled in a acquaintance's garden. She was also hooked on fentanyl.
As doctors treated her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and vomited.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had used fentanyl before arriving at the hospital and had only a brief window to get treated before she needed to go home to relapse. She thought she still had a month remaining to figure out how to get clean and deliver her child.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the leg infection was critical, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in rehabilitation.
A short time later, on the 12th of November, Stephanie delivered a baby girl weighing just over four pounds – early, little but surviving.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “I cannot.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been provided shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she relapsed. She felt worthless, berating herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her source declined to supply to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The common assumption that her affection for her child would make her recover only led to increased guilt and self-abuse, a impetus for her to return to drugs. Yet she could not simply will her addiction away, any more than she could eliminate a long-term illness.
The newborn was transferred to the NICU. When Stephanie finally saw her her, she was hooked up to tubes and leads, so little she thought she would break her. Embracing her at last, she felt empty. “I gazed upon her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to give her child the name Izzie, after the attendant who showed compassion to her.
Hospital staff told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are treated together, not apart.
In many parts of America, where a baby is found to have newborn addiction symptoms regularly, infants are still rushed to special care and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like Maddie’s Place is proving a simple point: when families are kept intact, recovery succeeds, foster placements fall and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility for the program, two staff members came to collect her.
She left the medical center still in withdrawal, anxious and doubtful about what would happen next.
At Maddie’s Place, Stephanie still worried that authorities would come seize her child – even though she was hesitant about parenting. The concern persisted: that at any time, someone could walk in and remove her child.
For the beginning period, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about survival. Substances came first; trust came last.
Stephanie had a trusted ally, but even that relationship was delicate. The people she loved always found ways to cause pain. She did not know how to love herself, not to mention anyone else.
Every day, staff from Maddie’s Place drove her to a recovery program, administered in pill form. Gradually, she was embracing sobriety.
She devoted all her time when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with intolerance to some formulas and obvious stomach troubles. She needed nutritional guidance. She also had sensory challenges and required an professional – all common issues for babies exposed to substances.
Seeing that even a young person understands the need for care, then I was capable. I could be a mom.
During a pre-holiday visit, Stephanie was in the common room, where parents in active addiction can come for supervised visits with their babies. A support specialist, a mentor, stopped by with her own family in tow to deliver baked goods. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in awe of the little newborn in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She has an image of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a decoration on her head, resting on the floor with the door behind her. She is slender. Her posture is humble so you cannot see her face. She is presenting her daughter on her leg for the young ones to see and they are gathered around, admiring and touching to the baby.
Jacob, eight, asked the parents: “What about the fathers?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if possible.
“When I have kids,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and her companion made eye contact. “I became emotional,” Stephanie said. “If this little kid could see that newborns require care, then I was able. I could parent.”
Tools for treating babies with exposure have been used for a long time.
The Finnegan NAS scale was established in 1975|
