A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Transformed Their Futures.
Eight months pregnant and in severe pain, a woman named Stephanie went to the ER after a serious infection started to spread up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had assembled in a acquaintance's garden. She was also hooked on fentanyl.
As medical staff managed her infection, she began to panic. The onset of withdrawal began. She slumped forward and vomited.
Stephanie finally broke down. “I need to leave. I have to go home and get high.”
She had consumed opioids before coming to the ER and had only a brief window to get treated before she had to return to relapse. She thought she still had four weeks left to figure out how to get clean and have this baby.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was severe, 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 not survive.
Izzie persuaded the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in rehabilitation.
A short time later, on a day in November 2022, Stephanie delivered a infant weighing 4lb 8oz – born before term, small but alive.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her anesthesia was ineffective, her last dose of fentanyl had been administered four hours before delivery.
She felt ill. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery repeatedly before birth, and felt terrible each time she relapsed. She felt hopeless, criticizing herself for not being able to overcome the challenge. An obstetrician told her to “simply” stop using. Even her supplier refused to sell to her when she became obviously with child.
“Yet I was unable,” she said. “I required assistance.”
The widespread belief that her love for her baby would make her quit only led to greater shame and negative self-talk, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could eliminate a chronic disease.
The baby was taken to the NICU. When Stephanie at last met her, she was connected to monitors, so small she thought she would hurt her. Cradling her initially, she felt nothing. “I gazed upon her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to name her baby Izzie, after the professional who provided support to her.
Nurses and doctors told her about a care center, a new kind of care center where parents and infants affected by substance use are treated together, not apart.
In much of the US, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals 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, results get better, custody cases decrease and future expenses reduce.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After verifying her eligibility for the program, two staff members came to bring her to the facility.
She departed the institution still in withdrawal, fearful and unsure about what would come next.
At Maddie’s Place, Stephanie still was concerned that child services would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could enter and separate them.
For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I was suspicious at that point.”
Homelessness, she said, was about getting by. Drugs came first; reliance 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 was unable to love herself, let alone anyone else.
Each day, staff from the facility took her to a treatment center, provided orally. Slowly, she was starting to get clean.
She utilized each moment beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and obvious stomach troubles. She needed feeding therapy. She also had sensory challenges and required an occupational therapist – all common issues for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I could do this. I could parent.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. An advocate, a recovery coach, visited with her own children in tow to bring treats. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in casual attire, a cap with a pompom on her head, sitting on the wooden floor with the exit nearby. She is thin. Her head is tilted forward so you cannot see her face. She is presenting her daughter on her lap for the young ones to see and they are gathered around, admiring and touching to the baby.
One child, eight, asked the moms: “Why are there no men?” The women attempted to clarify that the dads were busy, handling responsibilities, 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 will teach them about love.”
Stephanie and the specialist made eye contact. “I became emotional,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I found the courage. I would become a mother.”
Approaches for managing babies with exposure have existed for decades.
The assessment tool was created in 1975|
