She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Transformed Their Futures.
Eight months pregnant and in severe pain, the expectant mother arrived at the hospital emergency room after an infection began spreading up her legs. Jobless and without shelter, estranged from her family, she lived in a shed she had built in a acquaintance's garden. She was also addicted to fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She slumped forward and vomited.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and get high.”
She had used fentanyl 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 find a way to become sober and give birth.
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 critical, but medical staff detected she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she left, 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 withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is frequently utilized in addiction recovery.
A short time later, on 12 November 2022, Stephanie had a baby girl weighing just over four pounds – early, small but alive.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her anesthesia was ineffective, her last dose of fentanyl had been given a few hours prior to birth.
She felt sick. Ill-equipped for parenting. Undeserving.
Stephanie had sought recovery several times during pregnancy, and felt awful each time she relapsed. She felt without value, berating herself for not being able to achieve the unattainable. An obstetrician told her to “simply” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“Yet I was unable,” she said. “I needed help.”
The common assumption that her love for her baby would make her stop using only led to deeper self-loathing and self-harm, a impetus for her to relapse. Yet she could not simply will her addiction away, any more than she could overcome a persistent condition.
The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was hooked up to tubes and leads, so little she thought she would harm her. Holding her for the first time, she felt empty. “I just stared at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to give her child the name the same as her nurse, after the nurse who had been so kind to her.
Hospital staff told her about a care center, a unique recovery environment where parents and infants affected by substance use are cared for jointly, not apart.
In much of the US, where a baby is found to have newborn addiction symptoms every 18 minutes, infants are still rushed to special care and medicated 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, results get better, foster placements fall and overall savings increase.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, a couple of employees came to collect her.
She left the medical center still in detox, scared and uncertain about what would follow.
At the care center, Stephanie still was concerned that CPS would come take Izzie – even though she was not sure she wanted to keep her. The fear lingered: that at any time, someone could enter and remove her child.
For the first two weeks, Stephanie kept to herself. “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 enduring. Drugs came first; trust came last.
Stephanie had one close friend, but even that bond was fragile. The people she loved always found ways to hurt her. She did not know how to love herself, not to mention anyone else.
Every day, staff from Maddie’s Place drove her to a recovery program, given as medication. Gradually, she was embracing sobriety.
She devoted all her time 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 intolerance to some formulas and severe digestive problems. She needed feeding therapy. She also had heightened sensory issues and required an professional – 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.
During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for guided meetings with their babies. An advocate, a recovery coach, came over with her own children in tow to drop off cookies. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in admiration of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a beanie with a decoration on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her posture is humble so you cannot see her face. She is presenting her daughter on her leg for the children to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the parents: “Where are all the dads?” The parents responded that the dads were busy, engaged elsewhere, that they would be there given the chance.
“When I have kids,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and the specialist exchanged glances. “I broke down,” Stephanie said. “If this little kid could see that these babies deserve to be loved, then I could do this. I could parent.”
Methods to address drug-exposed newborns have been used for a long time.
The Finnegan NAS scale was created in 1975|
