She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother visited the ER after an infection began spreading up her legs. Without a job or home, estranged from her family, she stayed in a makeshift shelter she had constructed in a companion's property. She was also hooked on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Withdrawal was setting in. She leaned over the bed and threw up.
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 just enough time to get treated before she needed to go home to get high again. She thought she still had four weeks left to plan her recovery and give birth.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was severe, but physicians found she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be switched to methadone, a drug that alleviates cravings and is often prescribed in substance abuse treatment.
After five days, on a day in November 2022, Stephanie had a infant weighing a small weight – premature, tiny yet healthy.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was numb. Her pain relief did not work, her final administration of fentanyl had been given a few hours prior to birth.
She felt sick. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she failed. She felt hopeless, berating herself for not being able to do the impossible. An doctor told her to “only” stop using. Even her dealer declined to supply to her when she became obviously with child.
“But I couldn’t,” she said. “I needed help.”
The pervasive expectation that her bond with her newborn would make her stop using only led to increased guilt and self-abuse, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could eliminate a persistent condition.
The baby was taken to the NICU. When Stephanie eventually visited her, she was hooked up to tubes and leads, so tiny she thought she would harm her. Cradling her initially, she felt detached. “I just stared 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.
Medical personnel told her about Maddie’s Place, a unique recovery environment 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 regularly, infants are still rushed to special care and medicated while their mothers face parental assessments. But a developing system of centers like the care home is demonstrating a key fact: when parents and infants remain united, results get better, foster placements fall and future expenses reduce.
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 pick her up.
She stepped out of the hospital still in detox, fearful and unsure about what would happen next.
At Maddie’s Place, Stephanie still worried that child services would come take Izzie – even though she was hesitant about parenting. The concern persisted: that at any moment, someone could walk in and separate them.
For the first two weeks, Stephanie remained isolated. “I preferred to be alone,” she said. “I was suspicious at that point.”
Homelessness, she said, was about survival. Addiction came first; faith came last.
Stephanie had one close friend, but even that bond was fragile. The those close to her always found ways to hurt her. She was unable to love herself, much less anyone else.
Each day, staff from the facility drove her to a treatment center, provided orally. Over time, she was embracing sobriety.
She devoted all her time 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 adverse reactions to milk and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an occupational therapist – all typical problems for babies affected by withdrawal.
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 guided meetings with their babies. An advocate, a recovery coach, came over with her own family in tow to drop off cookies. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in wonder of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She keeps a photo of the moment. She is clad in black pants and a hoodie, a beanie with a pompom on her head, resting on the floor with the exit nearby. She is slender. Her head is tilted forward so you miss her features. She is lifting the baby on her knee for the children to see and they are standing close, showing interest to the baby.
One child, eight, asked the parents: “Where are all the dads?” The women attempted to clarify that the dads were busy, handling responsibilities, that they would be there if possible.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and Bunch-Smith looked at each other. “I just lost it and fell apart,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I found the courage. I could parent.”
Methods to address infants affected by substances have been used for a long time.
The assessment tool was created in 1975|
