She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
Eight months pregnant and in severe pain, the expectant mother went to the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had built in a friend’s yard. She was also hooked on fentanyl.
As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. She slumped forward and vomited.
Stephanie finally broke down. “I have to get out of here. I have to go home and get high.”
She had taken the drug before coming to the ER and had sufficient opportunity 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 give birth.
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 infection in her legs was serious, but physicians found she also had an ruptured membrane. The nurse, her nurse, warned her: if she departed, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be transitioned to methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
Five days later, on the 12th of November, Stephanie gave birth to a baby girl weighing a small weight – premature, small but alive.
When the attendant inquired if she wanted to hold her baby, Stephanie said “no.” She was detached. Her pain relief did not work, her final administration of fentanyl had been provided a few hours prior to birth.
She felt sick. Not ready for motherhood. Undeserving.
Stephanie had tried to get clean several times during pregnancy, and felt horrible each time she relapsed. She felt without value, criticizing herself for not being able to do the impossible. An OBGYN told her to “just” stop using. Even her dealer would not provide to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The pervasive expectation that her bond with her newborn would make her recover only led to increased guilt and self-abuse, a cause for her to use again. Yet she could not easily command her addiction away, any more than she could will away a persistent condition.
The baby was taken to the special care nursery. When Stephanie eventually visited her, she was connected to medical equipment, so small she thought she would break her. Embracing her at last, she felt detached. “I looked at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
After two days 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 innovative treatment home where parents and infants affected by substance use are supported as a unit, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) frequently, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face child-protection investigations. But a developing system of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, outcomes improve, fewer children enter care and future expenses reduce.
It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, two staff members came to pick her up.
She departed the institution still in withdrawal, fearful and unsure about what would come next.
At the facility, Stephanie still feared that child services would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any time, someone could enter and take her baby away.
For the initial fortnight, Stephanie remained isolated. “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 getting by. Substances came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The individuals she cared for always found ways to cause pain. She lacked the ability to care for herself, not to mention anyone else.
Every day, staff from the center drove her to a recovery program, provided orally. Slowly, she was starting to get clean.
She spent every minute outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and obvious stomach troubles. She needed nutritional guidance. She also had sensory challenges and required an professional – all frequent conditions for babies born with NAS.
Seeing that even a young person understands the need for care, then I found the strength. I could be a mom.
One afternoon before Thanksgiving, Stephanie sat in the visitation area, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a mentor, visited with her own family in tow to drop off cookies. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She holds a picture of the moment. She is clad in black pants and a hoodie, a gray knit hat with a pompom on her head, resting on the floor with the door behind her. She is thin. Her head is tilted forward so you miss her features. She is presenting her daughter on her lap for the children to see and they are standing close, showing interest to the baby.
Jacob, eight, asked the mothers: “Where are all the dads?” The moms tried to explain that the men were occupied, engaged elsewhere, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I will excel as a father. They will know they are valued.”
Stephanie and her companion exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I would become a mother.”
Methods to address babies with exposure have been used for a long time.
The assessment tool was created in 1975|
