She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother visited the ER after her infection worsened up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had assembled in a acquaintance's garden. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and vomited.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”
She had consumed opioids before coming to the ER and had just enough time to get treated before she needed to go home to use once more. She thought she still had several weeks to plan her recovery and give birth.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was severe, but doctors had discovered she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she departed, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be placed on methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.
A short time later, on a day in November 2022, Stephanie had a infant weighing just over four pounds – premature, tiny yet healthy.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “not now.” She was numb. Her anesthesia was ineffective, her last dose of fentanyl had been given four hours before delivery.
She felt unwell. Ill-equipped for parenting. Unworthy.
Stephanie had tried to get clean several times during pregnancy, and felt horrible each time she relapsed. She felt hopeless, blaming herself for not being able to achieve the unattainable. An obstetrician told her to “just” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“However, I failed,” she said. “I had to seek support.”
The common assumption that her bond with her newborn would make her stop using only led to greater shame and negative self-talk, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was hooked up to medical equipment, so tiny she thought she would break her. Holding her for the first time, she felt detached. “I gazed upon her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to name her baby Izzie, after the attendant who showed compassion to her.
Hospital staff told her about a specialized facility, a unique recovery environment where women and their babies are cared for jointly, not apart.
In much of the US, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is showing an important truth: when parents and infants remain united, recovery succeeds, fewer children enter care and future expenses reduce.
It took Stephanie a period to find strength to call, but she eventually made the call. After ensuring she qualified for the program, a couple of employees came to bring her to the facility.
She departed the institution still in detox, anxious and doubtful about what would follow.
At Maddie’s Place, Stephanie still feared that CPS would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could arrive and take her baby away.
For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about getting by. Substances came first; reliance came last.
Stephanie had a single companion, but even that connection was tenuous. The those close to her always found ways to cause pain. She was unable to care for herself, not to mention anyone else.
Every day, staff from the facility drove her to a clinic for methadone, given as medication. Gradually, she was beginning recovery.
She utilized each moment beyond therapy with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed feeding therapy. She also had sensory challenges and required an professional – all common issues for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I could do this. I would become a mother.
On a day prior to the holiday, Stephanie sat in the visitation area, where those still using can come for monitored interactions with their babies. Katie Bunch-Smith, a recovery coach, came over with her own children in tow to drop off cookies. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in wonder of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She keeps a photo of the moment. She is clad in black pants and a hoodie, a cap with a bobble on her head, sitting on the wooden floor with the entryway at her back. She is slender. Her posture is humble so you cannot see her face. She is presenting her daughter 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 parents: “Where are all the dads?” The parents responded that the men were occupied, handling responsibilities, that they would be there given the chance.
“When I have kids,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith made eye contact. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that infants need affection, then I could do this. I would become a mother.”
Methods to address drug-exposed newborns have existed for decades.
The assessment tool was developed in 1975|
