She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Transformed Their Futures.
Eight months pregnant and in severe pain, a woman named Stephanie went to the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, cut off from her relatives, she stayed in a makeshift shelter she had assembled in a companion's property. She was also dependent on fentanyl.
As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She leaned over the bed and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had used fentanyl before coming to the ER 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 have this baby.
The attending nurse disagreed. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was serious, but physicians found she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she departed, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
Five days later, on a day in November 2022, Stephanie had a baby girl weighing 4lb 8oz – born before term, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “not now.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been provided a few hours prior to birth.
She felt ill. Not ready for motherhood. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she failed. She felt hopeless, blaming herself for not being able to overcome the challenge. An obstetrician told her to “just” stop using. Even her supplier would not provide to her when she became obviously with child.
“However, I failed,” she said. “I needed help.”
The common assumption that her affection for her child would make her recover only led to increased guilt and self-abuse, a cause for her to use again. 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 eventually visited her, she was hooked up to monitors, so tiny she thought she would hurt her. Embracing her at last, she felt empty. “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 call her daughter the same as her nurse, after the attendant who showed compassion to her.
Nurses and doctors told her about a care center, a new kind of care center where women and their babies are supported as a unit, not apart.
In many parts of America, where a baby is identified with newborn addiction symptoms frequently, infants are still rushed to special care and treated with pharmaceuticals while their mothers face child-protection investigations. But a small, growing network of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, recovery succeeds, custody cases decrease and long-term costs decline.
It took Stephanie a period to find strength to call, but she eventually made the call. After ensuring she qualified for the program, care providers came to bring her to the facility.
She left the medical center still in withdrawal, fearful and unsure about what would follow.
At the care center, Stephanie still worried that authorities would come take Izzie – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could walk in and separate them.
For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about survival. Substances came first; reliance came last.
Stephanie had a single companion, but even that relationship was delicate. The those close to her always found ways to hurt her. She did not know how to care for herself, let alone anyone else.
Daily, staff from the center transported her to a clinic for methadone, administered in pill form. Gradually, she was embracing sobriety.
She spent every minute outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed dietary support. She also had increased sensitivity and required an occupational therapist – all common issues for babies born with NAS.
Seeing that even a young person understands the need for care, then I could do this. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where those still using can come for guided meetings with their babies. Katie Bunch-Smith, a peer support specialist, came over with her own family in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in awe of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She holds a picture of the moment. She is wearing casual attire, a cap with a decoration on her head, resting on the floor with the door behind her. She is lean. Her head is tilted forward so you miss her features. She is presenting her daughter on her leg for the young ones to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the parents: “Why are there no men?” The parents responded that the fathers had obligations, handling responsibilities, that they would be there given the chance.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and her companion exchanged glances. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that infants need affection, then I was able. I could parent.”
Tools for treating infants affected by substances have been available for years.
The Finnegan NAS scale was created in 1975|
