A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother visited the hospital emergency room after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she resided in a small structure she had built in a companion's property. She was also hooked on fentanyl.
As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. She slumped forward and vomited.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and get high.”
She had consumed opioids before arriving at the hospital and had just enough time to get treated before she needed to go home to relapse. She thought she still had several weeks to plan her recovery and deliver her child.
The attending nurse disagreed. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was serious, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is often prescribed in substance abuse treatment.
Five days later, on a day in November 2022, Stephanie had a daughter weighing just over four pounds – early, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her pain relief did not work, her previous intake of fentanyl had been administered four hours before delivery.
She felt sick. Not ready for motherhood. Not fit.
Stephanie had sought recovery several times during pregnancy, and felt awful each time she relapsed. She felt worthless, blaming herself for not being able to do the impossible. An OBGYN told her to “only” stop using. Even her source refused to sell to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The common assumption that her affection for her child would make her stop using only led to increased guilt and negative self-talk, a cause for her to return to drugs. Yet she could not just wish her addiction away, any more than she could eliminate a long-term illness.
The baby was taken to the neonatal intensive care unit. When Stephanie finally saw her her, she was attached to medical equipment, so little she thought she would hurt her. Embracing her at last, she felt detached. “I gazed upon her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
After two days she decided to give her child the name after her caregiver, after the professional who provided support to her.
Medical personnel told her about a care center, a unique recovery environment where parents and infants affected by substance use are cared for jointly, not apart.
In many parts of America, where a baby is found to have newborn addiction symptoms regularly, infants are still whisked to NICUs and given drugs while their mothers face child-protection investigations. But a small, growing network of centers like the care home is demonstrating a key fact: when mothers and babies stay together, recovery succeeds, fewer children enter care and future expenses reduce.
It took Stephanie a period to find strength to call, but she finally did. After confirming she would be a good fit 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 come next.
At Maddie’s Place, Stephanie still feared that child services would come take Izzie – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could walk in and remove her child.
For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Substances came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She lacked the ability to value herself, not to mention anyone else.
Every day, staff from the center took her to a treatment center, given as medication. Gradually, she was starting to get clean.
She spent every minute 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 adverse reactions to milk and pronounced gastrointestinal issues. She needed nutritional guidance. She also had sensory challenges and required an occupational therapist – all frequent conditions for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I was capable. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where those still using can come for monitored interactions with their babies. A support specialist, a recovery coach, visited with her own children in tow to drop off cookies. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in wonder of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She has an image of the moment. She is dressed in black pants and a hoodie, a gray knit hat with a bobble on her head, seated on the ground with the entryway at her back. She is lean. Her face is downcast so you do not see her expression. She is lifting the baby on her lap for the other kids to see and they are standing close, showing interest to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The moms tried to explain that the fathers had obligations, handling responsibilities, that they would be there if they could.
“When I have kids,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and Bunch-Smith made eye contact. “I broke down,” Stephanie said. “When a child recognized that infants need affection, then I could do this. I would become a mother.”
Approaches for managing drug-exposed newborns have been used for a long time.
The assessment tool was created in 1975|
