A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Rescued Both Lives.
In her eighth month of pregnancy and suffering, the expectant mother visited the ER after a serious infection started to spread up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had built in a friend’s yard. She was also dependent on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and threw up.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and use drugs.”
She had used fentanyl before seeking medical help and had only a brief window 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 have this baby.
The medical professional intervened. 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 leakage of amniotic fluid. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be transitioned to methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.
A short time later, on 12 November 2022, Stephanie gave birth to a daughter weighing 4lb 8oz – premature, little but surviving.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was emotionless. Her pain relief did not work, her final administration of fentanyl had been administered four hours before delivery.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she failed. She felt hopeless, criticizing 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.
“Yet I was unable,” she said. “I had to seek support.”
The common assumption that her affection for her child would make her stop using only led to deeper self-loathing and negative self-talk, 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 baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to tubes and leads, so little she thought she would harm her. Holding her for the first time, she felt nothing. “I looked at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Two days later she decided to call her daughter after her caregiver, after the nurse who had been so kind to her.
Medical personnel told her about Maddie’s Place, a unique recovery environment where parents and infants affected by substance use are treated together, not apart.
In numerous states, where a baby is identified with newborn addiction symptoms regularly, infants are still rushed to special care and medicated while their mothers face custody evaluations. But a small, growing network of centers like this facility is demonstrating a key fact: when mothers and babies stay together, recovery succeeds, foster placements fall and overall savings increase.
It took Stephanie some time to build confidence to call, but she finally did. After verifying her eligibility for the program, care providers came to collect her.
She stepped out of the hospital still in withdrawal, fearful and unsure about what would happen next.
At the facility, Stephanie still feared that child services would come seize her child – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could walk in and take her baby away.
For the first two weeks, Stephanie kept to herself. “I preferred to be alone,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about survival. Drugs came first; faith came last.
Stephanie had one close friend, but even that connection was tenuous. The individuals she cared for always found ways to cause pain. She did not know how to care for herself, not to mention anyone else.
Each day, staff from the facility drove her to a treatment center, administered in pill form. Gradually, she was starting to get clean.
She spent every minute outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed feeding therapy. She also had sensory challenges and required an occupational therapist – all frequent conditions for babies born with NAS.
When a child recognizes these infants need affection, then I found the strength. I could parent.
One afternoon before Thanksgiving, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. An advocate, a mentor, came over with her own children in tow to bring treats. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in awe of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She has an image of the moment. She is dressed in casual attire, a cap with a decoration on her head, resting on the floor with the entryway at her back. She is lean. Her head is tilted forward so you miss her features. She is presenting her daughter on her lap for the children to see and they are gathered around, showing interest to the baby.
A young boy, eight, asked the parents: “What about the fathers?” The women attempted to clarify that the dads were busy, engaged elsewhere, that they would be there if they could.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and the specialist looked at each other. “I became emotional,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I found the courage. I could parent.”
Tools for treating babies with exposure have existed for decades.
The evaluation method was established in 1975|
