A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother arrived at the ER after a serious infection started to spread up her legs. Without a job or home, cut off from her relatives, she stayed in a makeshift shelter she had constructed in a companion's property. She was also addicted to fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Withdrawal was setting in. She slumped forward and threw up.
Stephanie eventually collapsed. “I need to leave. I have to go home and use drugs.”
She had taken the drug before seeking medical help and had sufficient opportunity to get treated before she was compelled to leave to use once more. She thought she still had a month remaining to figure out how to get clean and deliver her child.
The attending nurse disagreed. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the infection in her legs was severe, but physicians found she also had an leakage of amniotic fluid. 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 at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a treatment that reduces symptoms and is often prescribed in rehabilitation.
A short time later, on a day in November 2022, Stephanie delivered a daughter weighing a small weight – born before term, tiny yet healthy.
When the nurse asked if she wanted to hold her baby, Stephanie said “not now.” She was emotionless. Her anesthesia was ineffective, her final administration of fentanyl had been provided shortly before she gave birth.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had attempted sobriety repeatedly before birth, and felt terrible each time she was unsuccessful. She felt without value, criticizing herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her dealer refused to sell to her when she became visibly pregnant.
“However, I failed,” she said. “I required assistance.”
The widespread belief that her affection for her child would make her stop using only led to deeper self-loathing and self-harm, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could eliminate 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 little she thought she would harm her. Cradling her initially, she felt detached. “I just stared at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Two days later she decided to name her baby Izzie, after the nurse who had been so kind to her.
Nurses and doctors told her about a specialized facility, a innovative treatment home where women and their babies are treated together, not apart.
In many parts of America, where a baby is found to have infant withdrawal condition every 18 minutes, infants are still rushed to special care and given drugs while their mothers face custody evaluations. But a limited but expanding group of centers like Maddie’s Place is showing an important truth: when parents and infants remain united, results get better, fewer children enter care and overall savings increase.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After confirming she would be a good fit for the program, a couple of employees came to pick her up.
She stepped out of the hospital still in detox, anxious and doubtful about what would come next.
At the facility, Stephanie still feared that child services would come seize her child – even though she was uncertain about motherhood. The concern persisted: that at any moment, someone could enter and separate them.
For the beginning period, Stephanie kept to herself. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about enduring. Addiction came first; faith came last.
Stephanie had one close friend, but even that relationship was delicate. The those close to her always found ways to let her down. She did not know how to love herself, let alone anyone else.
Each day, staff from the facility took her to a treatment center, given as medication. Gradually, she was beginning recovery.
She spent every minute when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and obvious stomach troubles. She needed dietary support. She also had sensory challenges and required an specialist – 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 sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. Katie Bunch-Smith, a mentor, came over with her own family in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor 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. “My past did not matter to them. None of those things mattered to them.”
She holds a picture of the moment. She is clad in black pants and a hoodie, a cap with a decoration on her head, seated on the ground with the door behind her. She is lean. Her head is tilted forward so you do not see her expression. She is presenting her daughter on her lap for the young ones to see and they are gathered around, fawning and reaching out to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The moms tried to explain that the men were occupied, handling responsibilities, that they would be there if they could.
“In the future,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I found the courage. I could parent.”
Tools for treating drug-exposed newborns have existed for decades.
The evaluation method was developed in 1975|
