A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother arrived at the medical facility after an infection began spreading up her legs. Without a job or home, separated from loved ones, she lived in a shed she had assembled in a friend’s yard. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. Symptoms of withdrawal emerged. She leaned over the bed and became sick.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and use drugs.”
She had consumed opioids before arriving at the hospital and had just enough time to get treated before she had to return to relapse. She thought she still had a month remaining to plan her recovery and deliver her child.
The attending nurse disagreed. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the infection in her legs was critical, but doctors had discovered she also had an leakage of amniotic fluid. The nurse, Izzie, warned her: if she walked out, she and her baby would not survive.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl periodically, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in rehabilitation.
After five days, on a day in November 2022, Stephanie gave birth to a infant weighing 4lb 8oz – premature, tiny yet healthy.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was detached. Her pain relief did not work, her previous intake of fentanyl had been administered four hours before delivery.
She felt ill. Unprepared to be a mother. Unworthy.
Stephanie had tried to get clean multiple times while expecting, and felt terrible each time she was unsuccessful. She felt worthless, berating herself for not being able to achieve the unattainable. An OBGYN told her to “simply” stop using. Even her supplier refused to sell to her when she became clearly expecting.
“However, I failed,” she said. “I required assistance.”
The widespread belief that her bond with her newborn would make her stop using only led to deeper self-loathing 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 persistent condition.
The newborn was transferred to the NICU. When Stephanie eventually visited her, she was connected to monitors, so tiny she thought she would hurt her. Holding her for the first time, she felt detached. “I gazed upon her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to give her child the name after her caregiver, after the attendant who showed compassion to her.
Medical personnel told her about a care center, a unique recovery environment where parents and infants affected by substance use are treated together, not apart.
In many parts of America, where a baby is identified with newborn addiction symptoms regularly, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like Maddie’s Place is demonstrating a key fact: when parents and infants remain united, recovery succeeds, foster placements fall and long-term costs decline.
It took Stephanie some time to build confidence to call, but she finally did. After confirming she would be a good fit for the program, care providers came to pick her up.
She left the medical center still in withdrawal, anxious and doubtful about what would follow.
At the care center, Stephanie still feared that authorities would come take Izzie – even though she was hesitant about parenting. The concern persisted: that at any point, someone could arrive and separate them.
For the initial fortnight, Stephanie stayed withdrawn. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about enduring. Substances came first; reliance came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to cause pain. She did not know how to care for herself, not to mention anyone else.
Each day, staff from the facility took her to a recovery program, provided orally. Gradually, she was beginning recovery.
She utilized each moment when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with sensitivity to certain foods and severe digestive problems. She needed nutritional guidance. She also had heightened sensory issues and required an occupational therapist – all frequent conditions for babies affected by withdrawal.
When a child recognizes these infants need affection, then I was capable. I would become a mother.
On a day prior to the holiday, Stephanie sat in the visitation area, where those still using can come for supervised visits with their babies. A support specialist, a mentor, stopped by with her own family in tow to bring treats. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in admiration of the tiny infant in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She keeps a photo of the moment. She is dressed in black pants and a hoodie, a cap with a decoration on her head, sitting on the wooden floor with the door behind her. She is thin. Her posture is humble so you do not see her expression. She is lifting the baby on her knee for the other kids to see and they are gathered around, 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, called away to other tasks, that they would be there if they could.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I will teach them about love.”
Stephanie and the specialist exchanged glances. “I just lost it and fell apart,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I could do this. I could parent.”
Approaches for managing drug-exposed newborns have been available for years.
The Finnegan NAS scale was established in 1975|
