A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother visited the ER after her infection worsened up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had constructed in a friend’s yard. She was also dependent on fentanyl.
As physicians addressed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She leaned over the bed and threw up.
Stephanie finally broke down. “I have to get out of here. I have to go home and take a hit.”
She had used fentanyl before arriving at the hospital and had just enough time to get treated before she needed to go home to relapse. She thought she still had a month remaining to figure out how to get clean and give birth.
The attending nurse disagreed. 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 severe, but medical staff detected she also had an ruptured membrane. The nurse, Izzie, warned her: if she departed, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a treatment that reduces symptoms and is commonly used in addiction recovery.
Five days later, on 12 November 2022, Stephanie delivered a daughter weighing just over four pounds – born before term, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been provided four hours before delivery.
She felt sick. Unprepared to be a mother. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she was unsuccessful. She felt worthless, criticizing herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her supplier declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her quit only led to deeper self-loathing and self-abuse, a trigger for her to return to drugs. Yet she could not just wish her addiction away, any more than she could overcome a long-term illness.
The infant was moved to the special care nursery. When Stephanie at last met her, she was attached to tubes and leads, so small she thought she would break her. Embracing her at last, she felt detached. “I looked at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to give her child the name Izzie, after the nurse who had been so kind to her.
Nurses and doctors told her about a specialized facility, 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 neonatal abstinence syndrome (NAS) frequently, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face custody evaluations. But a limited but expanding group of centers like Maddie’s Place is proving a simple point: when mothers and babies stay together, results get better, fewer children enter care and future expenses reduce.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After confirming she would be a good fit for the program, two staff members came to bring her to the facility.
She left the medical center still in recovery, scared and uncertain about what would follow.
At the care center, Stephanie still was concerned that authorities would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any time, someone could enter and separate them.
For the first two weeks, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Addiction came first; trust came last.
Stephanie had a trusted ally, but even that bond was fragile. The individuals she cared for always found ways to cause pain. She was unable to love herself, much less anyone else.
Every day, staff from the center took her to a treatment center, provided orally. Slowly, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and severe digestive problems. She needed feeding therapy. She also had heightened sensory issues and required an specialist – all frequent conditions for babies affected by withdrawal.
When a child recognizes these infants need affection, then I found the strength. I could be a mom.
On a day prior to the holiday, Stephanie was in the common room, where those still using can come for supervised visits with their babies. An advocate, a recovery coach, came over with her own children in tow to deliver baked goods. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She keeps a photo of the moment. She is clad in black pants and a hoodie, a beanie with a pompom on her head, seated on the ground with the exit nearby. She is lean. Her face is downcast so you miss her features. She is presenting her daughter on her leg for the other kids to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if they could.
“Once I become a parent,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I was able. I could parent.”
Approaches for managing babies with exposure have been available for years.
The assessment tool was developed in 1975|
