Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
Pregnant and experiencing intense discomfort, a woman named Stephanie arrived at the medical facility after her infection worsened up her legs. Without a job or home, estranged from her family, she lived in a shed she had built in a friend’s yard. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. Withdrawal was setting in. She leaned over the bed and became sick.
Stephanie eventually collapsed. “I need to leave. I have to go home and get high.”
She had taken the drug before arriving at the hospital and had just enough time to get treated before she was compelled to leave to relapse. She thought she still had a month remaining to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the medical facility declined to release her: the leg infection was serious, but physicians found she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she departed, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a medication that eases withdrawal and is often prescribed in substance abuse treatment.
After five days, on 12 November 2022, Stephanie gave birth to a baby girl weighing just over four pounds – early, tiny yet healthy.
When the nurse asked if she wanted to embrace her child, Stephanie said “not now.” She was numb. Her epidural had failed, her previous intake of fentanyl had been administered four hours before delivery.
She felt ill. Not ready for motherhood. Not fit.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she failed. She felt hopeless, criticizing 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.
“But I couldn’t,” she said. “I needed help.”
The pervasive expectation that her affection for her child would make her quit only led to increased guilt and self-harm, a impetus for her to relapse. Yet she could not easily command her addiction away, any more than she could eliminate a chronic disease.
The infant was moved to the NICU. When Stephanie eventually visited her, she was attached to tubes and leads, so small she thought she would harm her. Embracing her at last, she felt empty. “I just stared at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Following a brief period she decided to name her baby after her caregiver, after the attendant who showed compassion to her.
Nurses and doctors 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 numerous states, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still quickly moved to hospitals and given drugs while their mothers face child-protection investigations. But a limited but expanding group of centers like the care home is demonstrating a key fact: when mothers and babies stay together, results get better, fewer children enter care and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After verifying her eligibility for the program, a couple of employees came to bring her to the facility.
She departed the institution still in detox, anxious and doubtful about what would follow.
At the care center, Stephanie still feared that CPS would come seize her child – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could walk in and separate them.
For the initial fortnight, Stephanie remained isolated. “I preferred to be alone,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about getting by. Addiction came first; trust came last.
Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to hurt her. She did not know how to value herself, not to mention anyone else.
Daily, staff from the center transported her to a treatment center, given as medication. Gradually, she was beginning recovery.
She devoted all her time when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and severe digestive problems. She needed nutritional guidance. She also had increased sensitivity and required an occupational therapist – all common issues for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I could do this. I could be a mom.
One afternoon before Thanksgiving, Stephanie was in the common room, where parents in active addiction can come for supervised visits with their babies. A support specialist, a recovery coach, came over with her own children in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet 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. “My past did not matter to them. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in casual attire, a beanie with a bobble on her head, seated on the ground with the door behind her. She is lean. Her posture is humble so you do not see her expression. She is presenting her daughter on her leg for the other kids to see and they are crowding near, showing interest to the baby.
One child, eight, asked the mothers: “Where are all the dads?” The women attempted to clarify that the dads were busy, handling responsibilities, that they would be there if they could.
“When I have kids,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith made eye contact. “I broke down,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I could do this. I would become a mother.”
Tools for treating infants affected by substances have been available for years.
The assessment tool was developed in 1975|
