A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, a woman named Stephanie went to the hospital emergency room after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she stayed in a makeshift shelter she had built in a companion's property. She was also addicted to fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She leaned over the bed and vomited.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had taken the drug before arriving at the hospital and had only a brief window to get treated before she needed to go home to get high again. She thought she still had several weeks to find a way to become sober and deliver her child.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she walked out, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be switched to methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.
Five days later, on a day in November 2022, Stephanie gave birth to a infant weighing 4lb 8oz – born before term, tiny yet healthy.
When the attendant inquired if she wanted to embrace her child, Stephanie said “not now.” She was numb. Her pain relief did not work, her final administration of fentanyl had been administered four hours before delivery.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had sought recovery several times during pregnancy, and felt terrible each time she relapsed. She felt without value, blaming herself for not being able to achieve the unattainable. An doctor told her to “only” stop using. Even her source refused to sell to her when she became visibly pregnant.
“Yet I was unable,” she said. “I required assistance.”
The common assumption that her love for her baby would make her recover only led to deeper self-loathing and self-abuse, a cause for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a long-term illness.
The newborn was transferred to the NICU. When Stephanie eventually visited her, she was hooked up to tubes and leads, so small she thought she would hurt her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘What am I going to do with you?’” She continued to doubt she wanted to be her mother.
Two days later she decided to give her child the name after her caregiver, after the nurse who had been so kind to her.
Medical personnel told her about Maddie’s Place, a new kind of care center where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is found to have infant withdrawal condition every 18 minutes, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face child-protection investigations. But a limited but expanding group of centers like this facility is demonstrating a key fact: when mothers and babies stay together, outcomes improve, custody cases decrease and overall savings increase.
It took Stephanie some time to build confidence to call, but she eventually made the call. 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, anxious and doubtful about what would happen next.
At the facility, Stephanie still was concerned that authorities would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any moment, someone could arrive 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 didn’t have a lot of trust at that point.”
Life on the streets, she said, was about enduring. 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 was unable to care for herself, let alone anyone else.
Each day, staff from the facility drove her to a clinic for methadone, administered in pill form. Over time, she was starting to get clean.
She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and severe digestive problems. She needed nutritional guidance. She also had heightened sensory issues and required an occupational therapist – all typical problems for babies exposed to substances.
Seeing that even a young person understands the need for care, then I found the strength. I could parent.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where parents in active addiction can come for guided meetings with their babies. Katie Bunch-Smith, a peer support specialist, stopped by with her own five kids in tow to bring treats. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in admiration of the little newborn 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 has an image of the moment. She is clad in casual attire, a gray knit hat with a pompom on her head, resting on the floor with the door behind her. She is slender. Her face is downcast so you miss her features. She is presenting her daughter on her lap for the young ones to see and they are standing close, admiring and touching to the baby.
One child, eight, asked the mothers: “What about the fathers?” The parents responded that the dads were busy, called away to other tasks, that they would be there if possible.
“In the future,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and the specialist looked at each other. “I broke down,” Stephanie said. “If this little kid could see that newborns require care, then I could do this. I could be a mom.”
Approaches for managing babies with exposure have been used for a long time.
The Finnegan NAS scale was developed in 1975|
