She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother arrived at the ER after an infection began spreading up her legs. Jobless and without shelter, cut off from her relatives, she stayed in a makeshift shelter she had assembled in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Withdrawal was setting in. She leaned over the bed and threw up.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had taken the drug before arriving at the hospital and had only a brief window to get treated before she had to return to get high again. She thought she still had four weeks left to plan her recovery and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the infection in her legs was serious, but doctors had discovered she also had an ruptured membrane. The nurse, Izzie, 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 withdrawal could endanger her and the baby. Post-birth Stephanie would be placed on methadone, a treatment that reduces symptoms and is often prescribed in addiction recovery.
After five days, on a day in November 2022, Stephanie gave birth to a daughter weighing 4lb 8oz – premature, small but alive.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her epidural had failed, her last dose of fentanyl had been administered a few hours prior to birth.
She felt ill. Not ready for motherhood. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she relapsed. She felt hopeless, berating herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her dealer would not provide to her when she became obviously with child.
“But I couldn’t,” she said. “I had to seek support.”
The pervasive expectation that her affection for her child would make her recover only led to increased guilt and self-harm, a impetus for her to use again. Yet she could not just wish her addiction away, any more than she could eliminate a long-term illness.
The infant was moved to the NICU. When Stephanie eventually visited her, she was hooked up to medical equipment, so little she thought she would harm her. Embracing her at last, she felt detached. “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 give her child the name after her caregiver, after the attendant who showed compassion to her.
Nurses and doctors told her about Maddie’s Place, a innovative treatment home where parents and infants affected by substance use are supported as a unit, not apart.
In much of the US, where a baby is identified with infant withdrawal condition frequently, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is demonstrating a key fact: when families are kept intact, outcomes improve, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength to call, but she ultimately reached out. After verifying her eligibility for the program, two staff members came to collect her.
She stepped out of the hospital still in recovery, anxious and doubtful about what would happen next.
At the facility, Stephanie still was concerned that CPS would come seize her child – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could enter and separate them.
For the beginning period, Stephanie remained isolated. “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. Drugs came first; faith came last.
Stephanie had a single companion, but even that relationship was delicate. The people she loved always found ways to hurt her. She did not know how to value herself, let alone anyone else.
Every day, staff from Maddie’s Place transported her to a clinic for methadone, given as medication. Over time, she was embracing sobriety.
She spent every minute 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 adverse reactions to milk and severe digestive problems. She needed nutritional guidance. She also had sensory challenges and required an occupational therapist – all common issues for babies affected by withdrawal.
When a child recognizes these infants need affection, then I was capable. I would become a mother.
On a day prior to the holiday, Stephanie remained in the shared space, where parents in active addiction can come for supervised visits with their babies. An advocate, a recovery coach, visited with her own five kids in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in awe of the little newborn 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 has an image of the moment. She is clad in casual attire, a cap with a decoration on her head, seated on the ground with the door behind her. She is lean. Her posture is humble so you cannot see her face. She is holding Izzie up on her lap for the children to see and they are crowding near, fawning and reaching out to the baby.
A young boy, eight, asked the mothers: “Why are there no men?” The women attempted to clarify that the dads were busy, called away to other tasks, 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 exchanged glances. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that newborns require care, then I was able. I would become a mother.”
Methods to address infants affected by substances have existed for decades.
The evaluation method was developed in 1975|