Fentanyl Addiction During Pregnancy: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, the expectant mother visited the medical facility after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had constructed in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she grew increasingly fearful. Symptoms of withdrawal emerged. She slumped forward and became sick.
Stephanie finally broke down. “I have to get out of here. I have to go home and get high.”
She had consumed opioids before coming to the ER and had just enough time to get treated before she had to return to get high again. 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.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the leg infection was critical, but doctors had discovered she also had an ruptured membrane. The nurse, her nurse, warned her: if she walked out, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. After delivery Stephanie would be transitioned to methadone, a medication that eases withdrawal and is frequently utilized in rehabilitation.
After five days, on 12 November 2022, Stephanie delivered a daughter weighing a small weight – early, tiny yet healthy.
When the attendant inquired if she wanted to embrace her child, Stephanie said “I cannot.” She was detached. Her anesthesia was ineffective, her previous intake of fentanyl had been given a few hours prior to birth.
She felt unwell. Unprepared to be a mother. Unworthy.
Stephanie had sought recovery multiple times while expecting, and felt awful each time she relapsed. She felt without value, blaming herself for not being able to achieve the unattainable. An obstetrician told her to “simply” 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 pervasive expectation that her affection for her child would make her quit only led to greater shame and self-abuse, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The newborn was transferred to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to tubes and leads, so small she thought she would hurt her. Cradling her initially, she felt empty. “I just stared at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
After two days she decided to name her baby the same as her nurse, after the professional who provided support to her.
Nurses and doctors told her about Maddie’s Place, a unique recovery environment where parents and infants affected by substance use are cared for jointly, not apart.
In many parts of America, where a baby is diagnosed with neonatal abstinence syndrome (NAS) every 18 minutes, infants are still rushed to special care and given drugs 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, outcomes improve, custody cases decrease and future expenses reduce.
It took Stephanie some time to build confidence to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to collect her.
She left the medical center still in withdrawal, scared and uncertain about what would come next.
At the care center, Stephanie still was concerned that authorities would come seize her child – even though she was not sure she wanted to keep her. The concern persisted: that at any time, someone could walk in and take her baby away.
For the initial fortnight, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about enduring. Drugs came first; faith came last.
Stephanie had one close friend, but even that bond was fragile. The individuals she cared for always found ways to hurt her. She did not know how to love herself, much less anyone else.
Daily, staff from the facility took her to a clinic for methadone, administered in pill form. Over time, she was starting to get clean.
She utilized each moment outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her infant faced feeding challenges at first, with adverse reactions to milk and severe digestive problems. She needed dietary support. She also had increased sensitivity and required an specialist – all common issues for babies affected by withdrawal.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could parent.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where those still using can come for guided meetings with their babies. Katie Bunch-Smith, a mentor, visited with her own five kids in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in wonder of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
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 entryway at her back. She is lean. Her head is tilted forward so you do not see her expression. She is holding Izzie up on her leg for the young ones to see and they are crowding near, showing interest to the baby.
One child, eight, asked the moms: “Why are there no men?” The parents responded that the men were occupied, called away to other tasks, that they would be there if they could.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and her companion made eye contact. “I became emotional,” Stephanie said. “Seeing that even youth understand that these babies deserve to be loved, then I could do this. I could be a mom.”
Methods to address drug-exposed newborns have been available for years.
The evaluation method was developed in 1975|
