A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Rescued Both Lives.
In her eighth month of pregnancy and suffering, the expectant mother arrived at the medical facility after a serious infection started to spread up her legs. Unemployed and homeless, estranged from her family, she stayed in a makeshift shelter she had built in a companion's property. She was also hooked on fentanyl.
As doctors treated her infection, she began to panic. Withdrawal was setting in. She bent over the bedside and became sick.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and take a hit.”
She had consumed opioids before seeking medical help and had only a brief window to get treated before she was compelled to leave 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 going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was critical, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in rehabilitation.
A short time later, on 12 November 2022, Stephanie had a infant weighing just over four pounds – early, small but alive.
When the attendant inquired if she wanted to embrace her child, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her previous intake of fentanyl had been administered four hours before delivery.
She felt unwell. Not ready for motherhood. Undeserving.
Stephanie had tried to get clean several times during pregnancy, and felt awful each time she failed. She felt without value, berating herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her source refused to sell to her when she became obviously with child.
“However, I failed,” she said. “I required assistance.”
The pervasive expectation that her affection for her child would make her recover only led to deeper self-loathing and negative self-talk, a trigger for her to return to drugs. Yet she could not simply will her addiction away, any more than she could will away a chronic disease.
The baby was taken to the NICU. When Stephanie eventually visited her, she was hooked up to tubes and leads, so little she thought she would harm her. Holding her for the first time, she felt detached. “I gazed upon her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
Following a brief period she decided to give her child the name after her caregiver, after the professional who provided support to her.
Nurses and doctors told her about a specialized facility, a innovative treatment home where mothers and their drug-exposed newborns are supported as a unit, not apart.
In much of the US, where a baby is identified with infant withdrawal condition frequently, infants are still quickly moved to hospitals and given drugs while their mothers face custody evaluations. But a small, growing network of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, recovery succeeds, custody cases decrease and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After ensuring she qualified for the program, two staff members came to bring her to the facility.
She stepped out of the hospital still in detox, anxious and doubtful about what would happen next.
At the facility, Stephanie still was concerned that authorities would come take Izzie – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could enter and take her baby away.
For the initial fortnight, Stephanie remained isolated. “I avoided interaction,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about getting by. Substances came first; trust came last.
Stephanie had a single companion, but even that relationship was delicate. The people she loved always found ways to let her down. She was unable to value herself, much less anyone else.
Daily, staff from the center drove her to a recovery program, provided orally. Slowly, she was beginning recovery.
She devoted all her time outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her infant faced feeding challenges at first, with intolerance to some formulas and pronounced gastrointestinal issues. She needed nutritional guidance. She also had increased sensitivity 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 could do this. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where individuals struggling with substance use can come for supervised visits with their babies. Katie Bunch-Smith, a mentor, came over with her own children in tow to deliver baked goods. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. Such issues were irrelevant.”
She holds a picture of the moment. She is dressed in casual attire, a beanie with a decoration on her head, resting on the floor with the door behind her. She is slender. Her face is downcast so you cannot see her face. She is holding Izzie up on her knee for the young ones to see and they are crowding near, showing interest to the baby.
A young boy, eight, asked the moms: “Why are there no men?” The parents responded that the dads were busy, called away to other tasks, 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 the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I could be a mom.”
Approaches for managing drug-exposed newborns have been available for years.
The Finnegan NAS scale was developed in 1975|
