She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, the expectant mother visited the medical facility after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had built in a acquaintance's garden. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. Withdrawal was setting in. She bent over the bedside and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and get high.”
She had consumed opioids before coming to the ER and had sufficient opportunity to get treated before she had to return to relapse. She thought she still had four weeks left to plan her recovery and have this baby.
The attending nurse disagreed. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, her nurse, 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 abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.
A short time later, on the 12th of November, Stephanie delivered a baby girl weighing 4lb 8oz – premature, tiny yet healthy.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her final administration of fentanyl had been administered four hours before delivery.
She felt unwell. Ill-equipped for parenting. Unworthy.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she was unsuccessful. She felt hopeless, criticizing herself for not being able to overcome the challenge. An doctor told her to “simply” stop using. Even her source declined to supply to her when she became obviously with child.
“Yet I was unable,” she said. “I needed help.”
The pervasive expectation that her affection for her child would make her stop using only led to increased guilt and negative self-talk, a trigger for her to use again. Yet she could not just wish her addiction away, any more than she could will away a long-term illness.
The baby was taken to the NICU. When Stephanie finally saw her her, she was attached to monitors, so tiny she thought she would hurt her. Holding her for the first time, she felt detached. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
After two days she decided to give her child the name the same as her nurse, after the professional who provided support to her.
Hospital staff told her about a care center, a unique recovery environment where women and their babies are supported as a unit, not apart.
In much of the US, where a baby is identified with newborn addiction symptoms every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face custody evaluations. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when families are kept intact, recovery succeeds, foster placements fall and long-term costs decline.
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 pick her up.
She departed the institution still in recovery, fearful and unsure about what would follow.
At the facility, Stephanie still was concerned that CPS would come seize her child – even though she was uncertain about motherhood. The anxiety remained: that at any point, someone could walk in and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “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 getting by. Drugs came first; reliance came last.
Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to cause pain. She lacked the ability to value herself, let alone anyone else.
Every day, staff from the facility took her to a treatment center, administered in pill form. Slowly, she was starting to get clean.
She utilized each moment outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed nutritional guidance. She also had heightened sensory issues and required an occupational therapist – all frequent conditions for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I found the strength. I could be a mom.
During a pre-holiday visit, Stephanie was in the common room, where parents in active addiction can come for monitored interactions with their babies. A support specialist, a recovery coach, stopped by with her own family in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in wonder of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She holds a picture of the moment. She is wearing dark trousers and a sweatshirt, a cap with a pompom on her head, sitting on the wooden floor with the door behind her. She is thin. Her face is downcast so you cannot see her face. She is presenting her daughter on her leg for the children 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 men were occupied, engaged elsewhere, that they would be there if they could.
“When I have kids,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist exchanged glances. “I broke down,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I would become a mother.”
Tools for treating infants affected by substances have existed for decades.
The Finnegan NAS scale was established in 1975|
