A Pregnant Woman's Battle with Fentanyl Addiction: Choosing Motherhood Saved Them Both.
Eight months pregnant and in severe pain, a woman named Stephanie went to the hospital emergency room after an infection began spreading up her legs. Jobless and without shelter, estranged from her family, she resided in a small structure she had built in a companion's property. She was also hooked on fentanyl.
As medical staff managed her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and vomited.
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 was compelled to leave to relapse. She thought she still had four weeks left to figure out how to get clean and have this baby.
The medical professional intervened. 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 medical staff detected 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.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be placed on methadone, a treatment that reduces symptoms and is frequently utilized in addiction recovery.
After five days, on 12 November 2022, Stephanie delivered a baby girl weighing just over four pounds – premature, small but alive.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was emotionless. Her epidural had failed, her last dose of fentanyl had been administered four hours before delivery.
She felt unwell. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery repeatedly before birth, and felt awful each time she failed. She felt without value, criticizing herself for not being able to do the impossible. An doctor told her to “only” stop using. Even her dealer refused to sell to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her love for her baby would make her recover only led to greater shame and self-harm, a cause for her to relapse. Yet she could not easily command her addiction away, any more than she could eliminate a persistent condition.
The infant was moved to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to medical equipment, so tiny she thought she would break her. Cradling her initially, she felt detached. “I just stared at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to name her baby Izzie, after the professional who provided support to her.
Hospital staff told her about Maddie’s Place, a new kind of care center where women and their babies are treated together, not apart.
In many parts of America, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is demonstrating a key fact: when families are kept intact, recovery succeeds, fewer children enter care 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, a couple of employees came to bring her to the facility.
She left the medical center still in recovery, anxious and doubtful about what would come next.
At the facility, Stephanie still worried that CPS would come take Izzie – even though she was not sure she wanted to keep her. The anxiety remained: that at any time, someone could walk in and remove her child.
For the first two weeks, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about enduring. Addiction came first; faith came last.
Stephanie had one close friend, but even that relationship was delicate. The people she loved always found ways to hurt her. She lacked the ability to value herself, let alone anyone else.
Daily, staff from the facility took her to a recovery program, given as medication. Gradually, she was beginning recovery.
She devoted all her time beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and severe digestive problems. She needed feeding therapy. She also had increased sensitivity and required an specialist – all typical problems for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I was capable. I would become a mother.
One afternoon before Thanksgiving, Stephanie was in the common room, where those still using can come for guided meetings with their babies. An advocate, a peer support specialist, stopped by with her own five kids in tow to drop off cookies. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in awe of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She keeps a photo of the moment. She is wearing casual attire, a cap with a pompom on her head, resting on the floor with the exit nearby. She is slender. Her posture is humble so you miss her features. She is lifting the baby on her leg for the young ones to see and they are crowding near, fawning and reaching out to the baby.
Jacob, eight, asked the mothers: “What about the fathers?” The moms tried to explain that the dads were busy, engaged elsewhere, that they would be there if they could.
“In the future,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion 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.”
Approaches for managing infants affected by substances have been available for years.
The Finnegan NAS scale was established in 1975|
