She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Transformed Their Futures.
Pregnant and experiencing intense discomfort, the expectant mother visited the medical facility after a serious infection started to spread up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had built in a acquaintance's garden. She was also hooked on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. The onset of withdrawal began. She leaned over the bed and became sick.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and get high.”
She had consumed opioids before arriving at the hospital and had only a brief window to get treated before she had to return to use once more. She thought she still had four weeks left to plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the doctors would not let her go: the leg infection was critical, but physicians found she also had an ruptured membrane. The nurse, Izzie, warned her: if she left, she and her baby would be at risk of death.
Izzie persuaded the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be switched to methadone, a drug that alleviates cravings and is often prescribed in rehabilitation.
Five days later, on a day in November 2022, Stephanie gave birth to a daughter weighing 4lb 8oz – early, little but surviving.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was detached. Her anesthesia was ineffective, her final administration of fentanyl had been provided shortly before she gave birth.
She felt unwell. Ill-equipped for parenting. Undeserving.
Stephanie had sought recovery repeatedly before birth, and felt horrible each time she relapsed. She felt hopeless, blaming herself for not being able to overcome the challenge. An doctor told her to “simply” stop using. Even her dealer refused to sell to her when she became visibly pregnant.
“Yet I was unable,” she said. “I had to seek support.”
The pervasive expectation that her affection for her child would make her stop using only led to increased guilt and self-abuse, a impetus for her to use again. Yet she could not easily command her addiction away, any more than she could eliminate a long-term illness.
The newborn was transferred to the NICU. When Stephanie at last met her, she was connected to monitors, so little she thought she would hurt her. Cradling her initially, she felt detached. “I just stared at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to name her baby the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a innovative treatment home where parents and infants affected by substance use are supported as a unit, not apart.
In much of the US, where a baby is found to have newborn addiction symptoms frequently, infants are still rushed to special care and medicated while their mothers face custody evaluations. But a limited but expanding group of centers like the care home is showing an important truth: when parents and infants remain united, results get better, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she finally did. After confirming she would be a good fit for the program, two staff members came to collect her.
She stepped out of the hospital still in detox, fearful and unsure about what would come next.
At the facility, Stephanie still feared that CPS would come seize her child – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could arrive and take her baby away.
For the beginning period, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about getting by. Addiction came first; reliance 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 lacked the ability to value herself, much less anyone else.
Each day, staff from the center took her to a clinic for methadone, administered in pill form. Slowly, she was embracing sobriety.
She utilized each moment outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and pronounced gastrointestinal issues. She needed nutritional guidance. She also had heightened sensory issues and required an professional – all common issues for babies born with NAS.
Seeing that even a young person understands the need for care, then I was capable. I could parent.
During a pre-holiday visit, Stephanie sat in the visitation area, where individuals struggling with substance use can come for monitored interactions with their babies. Katie Bunch-Smith, a mentor, came over with her own children in tow to drop off cookies. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in admiration of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She keeps a photo of the moment. She is clad in casual attire, a cap with a decoration on her head, sitting on the wooden floor with the door behind her. She is slender. Her face is downcast so you cannot see her face. She is presenting her daughter on her knee for the children to see and they are standing close, admiring and touching to the baby.
Jacob, eight, asked the parents: “What about the fathers?” The women attempted to clarify that the dads were busy, engaged elsewhere, that they would be there given the chance.
“In the future,” Jacob said, “I’m going to be the best dad ever. They will know they are valued.”
Stephanie and the specialist exchanged glances. “I broke down,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I was able. I could parent.”
Methods to address infants affected by substances have been used for a long time.
The evaluation method was created in 1975|
