She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
In her eighth month of pregnancy and suffering, the expectant mother visited the ER after a serious infection started to spread up her legs. Jobless and without shelter, separated from loved ones, she resided in a small structure she had built in a companion's property. She was also addicted to fentanyl.
As physicians addressed her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and threw up.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and take a hit.”
She had consumed opioids before seeking medical help and had only a brief window to get treated before she was compelled to leave to use once more. She thought she still had several weeks to figure out how to get clean and have this baby.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“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 amniotic fluid leak. The nurse, her nurse, warned her: if she walked out, she and her baby would not survive.
She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that abstinence might harm 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 the 12th of November, Stephanie had a daughter weighing just over four pounds – early, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “not now.” She was emotionless. Her epidural had failed, her final administration of fentanyl had been administered a few hours prior to birth.
She felt ill. Unprepared to be a mother. Undeserving.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she failed. She felt hopeless, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “just” stop using. Even her supplier declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I needed help.”
The pervasive expectation 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 use again. Yet she could not simply will her addiction away, any more than she could overcome a long-term illness.
The baby was taken to the special care nursery. When Stephanie finally saw her her, she was connected to monitors, so small she thought she would hurt her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to name her baby the same as her nurse, after the professional who provided support to her.
Hospital staff told her about Maddie’s Place, a new kind of care center where women and their babies are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with newborn addiction symptoms every 18 minutes, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a limited but expanding group of centers like this facility is proving a simple point: when families are kept intact, results get better, foster placements fall and future expenses reduce.
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 bring her to the facility.
She left the medical center still in withdrawal, scared and uncertain about what would happen next.
At the care center, Stephanie still was concerned that authorities would come remove her daughter – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could walk in and separate them.
For the first two weeks, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about enduring. Substances came first; reliance came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to hurt her. She lacked the ability to love herself, let alone anyone else.
Every day, staff from Maddie’s Place transported her to a treatment center, given as medication. Over time, she was embracing sobriety.
She utilized each moment beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and severe digestive problems. She needed dietary support. She also had sensory challenges and required an specialist – all typical problems for babies born with NAS.
Seeing that even a young person understands the need for care, then I found the strength. I could be a mom.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. A support specialist, a peer support specialist, stopped by with her own five kids in tow to drop off cookies. They all gathered around 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 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 wearing casual attire, a beanie with a bobble on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her face is downcast so you miss her features. She is lifting the baby on her leg for the children to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the parents: “Where are all the dads?” The women attempted to clarify that the dads were busy, called away to other tasks, that they would be there if possible.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and her companion made eye contact. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I was able. I would become a mother.”
Methods to address babies with exposure have been available for years.
The assessment tool was created in 1975|
