She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother 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 built in a companion's property. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. The onset of withdrawal began. She leaned over the bed and became sick.
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 sufficient opportunity to get treated before she needed to go home to use once more. She thought she still had four weeks left to plan her recovery and deliver her child.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the leg infection was critical, but physicians found she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she departed, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be switched to methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.
Five days later, on the 12th of November, Stephanie had a daughter weighing just over four pounds – early, small but alive.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was emotionless. Her pain relief did not work, her previous intake of fentanyl had been administered a few hours prior to birth.
She felt sick. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she relapsed. She felt hopeless, berating herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her dealer would not provide to her when she became obviously with child.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her bond with her newborn would make her quit only led to increased guilt and self-abuse, a trigger for her to return to drugs. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The infant was moved to the NICU. When Stephanie at last met her, she was hooked up to tubes and leads, so little she thought she would harm her. Holding her for the first time, she felt nothing. “I looked at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a new kind of care center 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) every 18 minutes, infants are still rushed to special care and medicated while their mothers face parental assessments. But a developing system of centers like this facility is demonstrating a key fact: when mothers and babies stay together, results get better, fewer children enter care and future expenses reduce.
It took Stephanie some time to build confidence to call, but she finally did. After ensuring she qualified for the program, two staff members came to pick her up.
She left the medical center still in withdrawal, scared and uncertain about what would follow.
At the facility, Stephanie still worried that CPS would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could enter and take her baby away.
For the first two weeks, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about getting by. Drugs came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to cause pain. She lacked the ability to love herself, let alone anyone else.
Each day, staff from Maddie’s Place drove her to a treatment center, provided orally. Over time, she was embracing sobriety.
She devoted all her time beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and obvious stomach troubles. She needed feeding therapy. She also had sensory challenges and required an professional – all frequent conditions for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I was capable. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a recovery coach, visited with her own children in tow to bring treats. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in admiration of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She keeps a photo of the moment. She is dressed in black pants and a hoodie, a beanie with a decoration on her head, resting on the floor with the entryway at her back. She is lean. Her posture is humble so you do not see her expression. She is lifting the baby on her lap for the young ones to see and they are standing close, showing interest to the baby.
A young boy, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the dads were busy, called away to other tasks, that they would be there given the chance.
“In the future,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith made eye contact. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that newborns require care, then I could do this. I could be a mom.”
Approaches for managing infants affected by substances have been available for years.
The assessment tool was established in 1975|
