A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
Eight months pregnant and in severe pain, the expectant mother went to the hospital emergency room after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she lived in a shed she had assembled in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she started to feel anxious. Withdrawal was setting in. She bent over the bedside and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had taken the drug before seeking medical help 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 figure out how to get clean and deliver her child.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the leg infection was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she walked out, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.
After five days, on 12 November 2022, Stephanie delivered a daughter weighing a small weight – born before term, small but alive.
When the attendant inquired if she wanted to embrace her child, Stephanie said “I cannot.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been given a few hours prior to birth.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had tried to get clean several times during pregnancy, and felt terrible each time she relapsed. She felt hopeless, berating herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her source refused to sell to her when she became visibly pregnant.
“But I couldn’t,” she said. “I needed help.”
The widespread belief that her affection for her child would make her recover only led to increased guilt and self-harm, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was hooked up to monitors, so small she thought she would harm her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to call her daughter the same as her nurse, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a unique recovery environment where parents and infants affected by substance use are treated together, not apart.
In many parts of America, where a baby is identified with neonatal abstinence syndrome (NAS) frequently, infants are still whisked to NICUs and given drugs while their mothers face child-protection investigations. But a developing system of centers like Maddie’s Place is demonstrating a key fact: when families are kept intact, recovery succeeds, fewer children enter care and overall savings increase.
It took Stephanie a period to find strength to call, but she finally did. After verifying her eligibility for the program, a couple of employees came to pick her up.
She stepped out of the hospital still in withdrawal, scared and uncertain about what would happen next.
At Maddie’s Place, Stephanie still worried that authorities would come remove her daughter – even though she was uncertain about motherhood. The anxiety remained: that at any moment, someone could walk in and separate them.
For the first two weeks, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about getting by. Addiction came first; trust came last.
Stephanie had a single companion, but even that connection was tenuous. The individuals she cared for always found ways to hurt her. She did not know how to value herself, let alone anyone else.
Daily, staff from Maddie’s Place took her to a clinic for methadone, administered in pill form. Slowly, she was starting to get clean.
She devoted all her time 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 dietary support. She also had increased sensitivity and required an specialist – all common issues for babies affected by withdrawal.
When a child recognizes these infants need affection, then I could do this. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a peer support specialist, came over with her own family in tow to deliver baked goods. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The young ones stared in wonder of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She keeps a photo of the moment. She is clad in dark trousers and a sweatshirt, a cap with a decoration on her head, sitting on the wooden floor with the door behind her. She is thin. Her posture is humble so you miss her features. She is presenting her daughter on her lap for the children to see and they are crowding near, admiring and touching to the baby.
Jacob, eight, asked the parents: “Why are there no men?” The parents responded that the fathers had obligations, called away to other tasks, that they would be there given the chance.
“In the future,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I could be a mom.”
Tools for treating infants affected by substances have been available for years.
The Finnegan NAS scale was created in 1975|
