She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie visited the ER after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she resided in a small structure she had assembled in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Withdrawal was setting in. She leaned over the bed and became sick.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and take a hit.”
She had consumed opioids before arriving at the hospital 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 medical professional intervened. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was severe, but doctors had discovered she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be placed on methadone, a medication that eases withdrawal and is frequently utilized in rehabilitation.
Five days later, on the 12th of November, Stephanie delivered a baby girl weighing a small weight – premature, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her epidural had failed, her previous intake of fentanyl had been provided shortly before she gave birth.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she failed. She felt hopeless, criticizing herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her source declined to supply to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her quit only led to deeper self-loathing and self-abuse, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.
The newborn was transferred to the special care nursery. When Stephanie finally saw her her, she was connected to medical equipment, so little she thought she would hurt her. Holding her for the first time, she felt detached. “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 call her daughter Izzie, after the nurse who had been so kind to her.
Hospital staff told her about Maddie’s Place, a new kind of care center where mothers and their drug-exposed newborns are cared for jointly, not apart.
In much of the US, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still whisked to NICUs and given drugs while their mothers face child-protection investigations. But a limited but expanding group of centers like this facility is showing an important truth: when parents and infants remain united, outcomes improve, fewer children enter care and long-term costs decline.
It took Stephanie some time to build confidence 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 detox, anxious and doubtful about what would come next.
At the care center, Stephanie still was concerned that child services would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any moment, someone could arrive and separate them.
For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about getting by. Drugs came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to cause pain. She did not know how to care for herself, not to mention anyone else.
Each day, staff from the facility drove her to a recovery program, administered in pill form. Gradually, she was starting to get clean.
She utilized each moment when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed nutritional guidance. She also had increased sensitivity 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 was capable. I would become a mother.
During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for monitored interactions with their babies. A support specialist, a mentor, came over with her own children in tow to deliver baked goods. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The young ones stared 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. None of those things mattered to them.”
She has an image of the moment. She is wearing casual attire, a cap with a decoration on her head, seated on the ground with the exit nearby. She is lean. Her head is tilted forward so you do not see her expression. She is presenting her daughter on her knee for the other kids to see and they are crowding near, admiring and touching to the baby.
Jacob, eight, asked the parents: “Where are all the dads?” The women attempted to clarify that the fathers had obligations, called away to other tasks, 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 Bunch-Smith looked at each other. “I became emotional,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I was able. I could parent.”
Methods to address babies with exposure have been available for years.
The evaluation method was created in 1975|
