A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Rescued Both Lives.
Eight months pregnant and in severe pain, a woman named Stephanie went to the hospital emergency room after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she stayed in a makeshift shelter she had constructed in a acquaintance's garden. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She bent over the bedside and vomited.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before coming to the ER and had only a brief window to get treated before she was compelled to leave to use once more. She thought she still had four weeks left to find a way to become sober and deliver her child.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was severe, but physicians found she also had an ruptured membrane. The nurse, Izzie, warned her: if she left, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be transitioned to methadone, a drug that alleviates cravings and is often prescribed in addiction recovery.
Five days later, on a day in November 2022, Stephanie had a daughter weighing just over four pounds – born before term, little but surviving.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been given shortly before she gave birth.
She felt ill. Unprepared to be a mother. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she relapsed. She felt without value, criticizing herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her dealer would not provide to her when she became visibly pregnant.
“However, I failed,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her quit only led to increased guilt and negative self-talk, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The infant was moved to the neonatal intensive care unit. When Stephanie at last met her, she was connected to medical equipment, so small she thought she would break her. Holding her for the first time, she felt empty. “I just stared at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to give her child the name Izzie, after the professional who provided support to her.
Nurses and doctors told her about Maddie’s Place, a unique recovery environment where women and their babies are cared for jointly, not apart.
In much of the US, where a baby is identified with infant withdrawal condition frequently, infants are still rushed to special care and treated with pharmaceuticals while their mothers face custody evaluations. But a small, growing network 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 ultimately reached out. After ensuring she qualified for the program, two staff members came to collect her.
She left the medical center still in recovery, fearful and unsure about what would follow.
At Maddie’s Place, Stephanie still was concerned that authorities 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 enter and remove her child.
For the first two weeks, Stephanie stayed withdrawn. “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.”
Life on the streets, she said, was about getting by. Addiction came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to let her down. She was unable to care for herself, much less anyone else.
Daily, staff from the facility took her to a treatment center, given as medication. Gradually, she was beginning recovery.
She devoted all her time 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 sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an professional – all common issues for babies affected by withdrawal.
When a child recognizes these infants need affection, then I was capable. I could be a mom.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. A support specialist, a mentor, stopped by with her own family in tow to drop off cookies. They all assembled beside 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 were innocent,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She has an image of the moment. She is dressed 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 thin. Her head is tilted forward so you cannot see her face. She is holding Izzie up on her lap for the other kids to see and they are gathered around, fawning and reaching out to the baby.
One child, eight, asked the moms: “Why are there no men?” The moms tried to explain that the men were occupied, engaged elsewhere, 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 her companion exchanged glances. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I was able. I could be a mom.”
Methods to address drug-exposed newborns have existed for decades.
The assessment tool was created in 1975|
