A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
In her eighth month of pregnancy and suffering, a woman named Stephanie arrived at the medical facility after an infection began spreading up her legs. Jobless and without shelter, separated from loved ones, she lived in a shed she had assembled in a friend’s yard. She was also dependent on fentanyl.
As physicians addressed her infection, she started to feel anxious. The onset of withdrawal began. She slumped forward and became sick.
Stephanie eventually collapsed. “I have to get out of here. I have to go home and take a hit.”
She had taken the drug before arriving at the hospital and had just enough time to get treated before she had to return to get high again. She thought she still had a month remaining to plan her recovery and have this baby.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the condition in her limbs was critical, but doctors had discovered she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she left, she and her baby would not survive.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be switched to methadone, a medication that eases withdrawal and is often prescribed in substance abuse treatment.
A short time later, on 12 November 2022, Stephanie gave birth to a baby girl weighing 4lb 8oz – premature, tiny yet healthy.
When the nurse asked if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been provided a few hours prior to birth.
She felt unwell. Not ready for motherhood. Undeserving.
Stephanie had sought recovery several times during pregnancy, and felt terrible each time she failed. She felt hopeless, blaming herself for not being able to achieve the unattainable. An OBGYN told her to “just” stop using. Even her dealer refused to sell to her when she became obviously with child.
“Yet I was unable,” she said. “I needed help.”
The common assumption that her bond with her newborn would make her quit only led to deeper self-loathing and negative self-talk, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could eliminate a chronic disease.
The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was attached to tubes and leads, so small she thought she would harm her. Holding her for the first time, she felt empty. “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 name her baby the same as her nurse, after the professional who provided support to her.
Hospital staff told her about a care center, a unique recovery environment where mothers and their drug-exposed newborns are cared for jointly, not apart.
In many parts of America, where a baby is identified with infant withdrawal condition regularly, infants are still quickly moved to hospitals and medicated while their mothers face parental assessments. But a small, growing network of centers like this facility is demonstrating a key fact: 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 finally did. After confirming she would be a good fit for the program, two staff members came to collect her.
She left the medical center still in recovery, fearful and unsure about what would follow.
At Maddie’s Place, Stephanie still feared that CPS would come remove her daughter – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could walk in and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about enduring. Substances came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to hurt her. She did not know how to value herself, let alone anyone else.
Daily, staff from Maddie’s Place drove her to a recovery program, provided orally. Gradually, she was beginning recovery.
She spent every minute when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed dietary support. 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 was capable. I could parent.
On a day prior to the holiday, Stephanie sat in the visitation area, where individuals struggling with substance use can come for guided meetings with their babies. A support specialist, a mentor, came over with her own five kids in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe of the tiny infant in Stephanie’s arms. “They showed no judgment,” 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 wearing dark trousers and a sweatshirt, a cap with a bobble on her head, seated on the ground with the entryway at her back. She is slender. 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.
Jacob, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the fathers had obligations, engaged elsewhere, that they would be there if they could.
“In the future,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and the specialist made eye contact. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I could do this. I would become a mother.”
Methods to address infants affected by substances have existed for decades.
The assessment tool was developed in 1975|
