She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
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 companion's property. She was also dependent on fentanyl.
As doctors treated her infection, she started to feel anxious. The onset of withdrawal began. She leaned over the bed and threw up.
Stephanie ultimately gave in. “I need to leave. I have to go home and get high.”
She had taken the drug before coming to the ER and had just enough time to get treated before she was compelled to leave to use once more. She thought she still had four weeks left to figure out how to get clean and give birth.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was serious, but doctors had discovered she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be placed on methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
A short time later, on 12 November 2022, Stephanie gave birth to a baby girl weighing 4lb 8oz – born before term, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was numb. Her epidural had failed, her previous intake of fentanyl had been administered four hours before delivery.
She felt ill. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery several times during pregnancy, and felt terrible each time she relapsed. She felt without value, criticizing herself for not being able to achieve the unattainable. An OBGYN told her to “just” stop using. Even her dealer would not provide to her when she became clearly expecting.
“However, I failed,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her quit only led to greater shame and self-abuse, a cause for her to relapse. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to monitors, so tiny she thought she would harm her. Embracing her at last, she felt empty. “I gazed upon her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Two days later she decided to name her baby Izzie, after the professional who provided support to her.
Nurses and doctors told her about Maddie’s Place, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In many parts of America, where a baby is diagnosed with newborn addiction symptoms every 18 minutes, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a small, growing network of centers like this facility is showing an important truth: 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, care providers came to collect her.
She left the medical center still in withdrawal, scared and uncertain about what would come next.
At the care center, Stephanie still worried that CPS 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 initial fortnight, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about survival. Substances came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to let her down. She was unable to love herself, let alone anyone else.
Daily, staff from the facility transported her to a clinic for methadone, given as medication. Over time, she was beginning recovery.
She spent every minute outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and severe digestive problems. She needed nutritional guidance. She also had increased sensitivity and required an professional – all typical problems for babies affected by withdrawal.
When a child recognizes these infants need affection, then I found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie was in the common room, where parents in active addiction can come for guided meetings with their babies. Katie Bunch-Smith, a mentor, visited with her own children in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a bobble on her head, sitting on the wooden floor with the door behind her. She is slender. Her face is downcast so you do not see her expression. She is holding Izzie up on her lap for the young ones to see and they are crowding near, admiring and touching to the baby.
A young boy, eight, asked the parents: “Where are all the dads?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion made eye contact. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I was able. I would become a mother.”
Methods to address drug-exposed newborns have been available for years.
The Finnegan NAS scale was developed in 1975|
