She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
Eight months pregnant and in severe pain, the expectant mother visited the ER after an infection began spreading up her legs. Unemployed and homeless, cut off from her relatives, she resided in a small structure she had constructed in a companion's property. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. The onset of withdrawal began. She leaned over the bed and threw up.
Stephanie finally broke down. “Listen, I gotta go. 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 needed to go home to relapse. She thought she still had several weeks to figure out how to get clean and deliver her child.
The medical professional intervened. She told Stephanie she was not allowed to leave.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the leg infection was critical, but medical staff detected she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
After five days, on 12 November 2022, Stephanie had a baby girl weighing a small weight – early, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her anesthesia was ineffective, her final administration of fentanyl had been given a few hours prior to birth.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had tried to get clean multiple times while expecting, and felt awful each time she was unsuccessful. She felt worthless, blaming herself for not being able to overcome the challenge. An obstetrician told her to “just” stop using. Even her dealer declined to supply to her when she became clearly expecting.
“But I couldn’t,” she said. “I needed help.”
The widespread belief that her affection for her child would make her quit only led to increased guilt and negative self-talk, a cause for her to relapse. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The baby was taken to the NICU. When Stephanie at last met her, she was hooked up to medical equipment, so little she thought she would break her. Embracing her at last, she felt empty. “I looked at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
After two days she decided to name her baby after her caregiver, after the nurse who had been so kind to her.
Medical personnel told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are cared for jointly, not apart.
In much of the US, where a baby is identified with infant withdrawal condition regularly, infants are still whisked to NICUs and medicated while their mothers face parental assessments. But a small, growing network of centers like the care home is showing an important truth: when mothers and babies stay together, recovery succeeds, custody cases decrease and long-term costs decline.
It took Stephanie a period to find strength to call, but she ultimately reached out. After confirming she would be a good fit for the program, a couple of employees came to collect her.
She stepped out of the hospital still in recovery, anxious and doubtful about what would follow.
At the facility, Stephanie still worried that CPS would come remove her daughter – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could walk in and separate them.
For the initial fortnight, 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 enduring. Addiction came first; trust came last.
Stephanie had one close friend, but even that connection was tenuous. The those close to her always found ways to let her down. She was unable to care for herself, much less anyone else.
Daily, staff from Maddie’s Place took her to a clinic for methadone, given as medication. Over time, she was embracing sobriety.
She spent every minute outside treatment 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 dietary support. She also had sensory challenges and required an specialist – all frequent conditions for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I could do this. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. An advocate, a recovery coach, came over with her own family in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in awe of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in black pants and a hoodie, a gray knit hat with a decoration on her head, sitting on the wooden floor with the entryway at her back. She is slender. Her posture is humble so you do not see her expression. She is holding Izzie up on her knee for the children to see and they are crowding near, showing interest to the baby.
Jacob, eight, asked the mothers: “Where are all the dads?” The parents responded that the dads were busy, handling responsibilities, that they would be there if possible.
“In the future,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that infants need affection, then I found the courage. I could parent.”
Tools for treating infants affected by substances have been available for years.
The assessment tool was developed in 1975|
