Fentanyl Addiction During Pregnancy: The Decision to Keep Her Child Rescued Both Lives.
Eight months pregnant and in severe pain, the expectant mother went to the ER after a serious infection started to spread up her legs. Unemployed and homeless, separated from loved ones, she stayed in a makeshift shelter she had assembled in a friend’s yard. She was also hooked on fentanyl.
As doctors treated her infection, she started to feel anxious. Symptoms of withdrawal emerged. She leaned over the bed and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had taken the drug before seeking medical help and had only a brief window to get treated before she needed to go home to use once more. She thought she still had four weeks left to find a way to become sober and give birth.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was serious, but medical staff detected she also had an ruptured membrane. The nurse, Izzie, warned her: if she left, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie controlled doses of fentanyl every few hours, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be transitioned to methadone, a treatment that reduces symptoms and is commonly used in addiction recovery.
After five days, on the 12th of November, Stephanie had a infant weighing 4lb 8oz – early, little but surviving.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was emotionless. Her epidural had failed, her final administration of fentanyl had been given a few hours prior to birth.
She felt unwell. Unprepared to be a mother. Not fit.
Stephanie had tried to get clean repeatedly before birth, and felt terrible each time she relapsed. She felt worthless, berating herself for not being able to overcome the challenge. An doctor told her to “just” stop using. Even her supplier refused to sell to her when she became visibly pregnant.
“However, I failed,” she said. “I needed help.”
The common assumption that her love for her baby would make her recover only led to increased guilt and negative self-talk, a cause for her to return to drugs. Yet she could not easily command her addiction away, any more than she could will away a long-term illness.
The infant was moved to the special care nursery. When Stephanie at last met her, she was hooked up to tubes and leads, so little she thought she would hurt 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.
After two days she decided to call her daughter Izzie, after the nurse who had been so kind to her.
Nurses and doctors told her about Maddie’s Place, a new kind of care center where parents and infants affected by substance use are supported as a unit, not apart.
In numerous states, where a baby is found to have newborn addiction symptoms regularly, infants are still quickly moved to hospitals and treated with pharmaceuticals while their mothers face parental assessments. But a limited but expanding group of centers like Maddie’s Place is demonstrating a key fact: when parents and infants remain united, recovery succeeds, 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 collect her.
She departed the institution still in recovery, fearful and unsure about what would come next.
At the facility, Stephanie still worried that authorities would come seize her child – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could arrive and remove her child.
For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Substances came first; faith came last.
Stephanie had a trusted ally, but even that bond was fragile. The people she loved always found ways to let her down. She did not know how to love herself, not to mention anyone else.
Each day, staff from Maddie’s Place took her to a treatment center, given as medication. Over time, she was embracing sobriety.
She utilized each moment 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 sensitivity to certain foods and obvious stomach troubles. She needed feeding therapy. She also had increased sensitivity and required an occupational therapist – all frequent conditions for babies affected by withdrawal.
When a child recognizes these infants need affection, then I found the strength. I could be a mom.
During a pre-holiday visit, Stephanie was in the common room, where those still using can come for monitored interactions with their babies. A support specialist, a mentor, came over with her own family in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in awe of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. None of those things mattered to them.”
She has an image of the moment. She is wearing casual attire, a cap with a pompom on her head, sitting on the wooden floor with the entryway at her back. She is lean. Her face is downcast so you cannot see her face. She is presenting her daughter on her leg for the children to see and they are standing close, admiring and touching to the baby.
One child, eight, asked the mothers: “What about the fathers?” The women attempted to clarify that the fathers had obligations, handling responsibilities, that they would be there given the chance.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I found the courage. I could parent.”
Methods to address babies with exposure have existed for decades.
The assessment tool was established in 1975|
