She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie visited the hospital emergency room after a serious infection started to spread up her legs. Without a job or home, separated from loved ones, she resided in a small structure she had assembled in a acquaintance's garden. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had consumed opioids before coming to the ER and had only a brief window to get treated before she needed to go home to use once more. She thought she still had several weeks to plan her recovery and give birth.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was critical, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be switched to methadone, a treatment that reduces symptoms and is commonly used in rehabilitation.
A short time later, on a day in November 2022, Stephanie delivered 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 “I cannot.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been given shortly before she gave birth.
She felt unwell. Unprepared to be a mother. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt awful each time she was unsuccessful. She felt worthless, berating herself for not being able to overcome the challenge. An OBGYN told her to “only” stop using. Even her dealer refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I required assistance.”
The common assumption that her affection for her child would make her recover only led to greater shame and self-abuse, a trigger for her to use again. Yet she could not just wish her addiction away, any more than she could will away a persistent condition.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was hooked up to tubes and leads, so small she thought she would break her. Cradling her initially, she felt empty. “I looked at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to name her baby after her caregiver, after the nurse who had been so kind to her.
Hospital staff told her about a care center, a innovative treatment home where parents and infants affected by substance use are treated together, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still whisked to NICUs and given drugs while their mothers face custody evaluations. But a limited but expanding group of centers like this facility is proving a simple point: when families are kept intact, results get better, foster placements fall and overall savings increase.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, care providers came to collect her.
She stepped out of the hospital still in withdrawal, fearful and unsure about what would come next.
At Maddie’s Place, Stephanie still feared that authorities would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could arrive and separate them.
For the initial fortnight, Stephanie remained isolated. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about getting by. Addiction came first; trust came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to cause pain. She was unable to value herself, not to mention anyone else.
Daily, staff from the center drove her to a recovery program, given as medication. Over time, she was embracing sobriety.
She utilized each moment outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed feeding therapy. She also had heightened sensory issues and required an professional – all common issues for babies exposed to substances.
If this little kid could see that these babies deserve to be loved, then I could do this. I could parent.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for monitored interactions with their babies. A support specialist, a peer support specialist, visited with her own children in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She holds a picture of the moment. She is wearing black pants and a hoodie, a gray knit hat with a pompom on her head, resting on the floor with the entryway at her back. She is lean. Her head is tilted forward so you miss her features. She is holding Izzie up on her knee for the children to see and they are standing close, fawning and reaching out to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The parents responded that the dads were busy, engaged elsewhere, that they would be there if they could.
“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. “If this little kid could see that newborns require care, then I found the courage. I could parent.”
Approaches for managing drug-exposed newborns have been used for a long time.
The evaluation method was established in 1975|
