Fentanyl Addiction During Pregnancy: How Keeping Her Baby Transformed Their Futures.
Eight months pregnant and in severe pain, the expectant mother went to the medical facility after her infection worsened up her legs. Jobless and without shelter, separated from loved ones, she stayed in a makeshift shelter she had constructed in a friend’s yard. She was also addicted to fentanyl.
As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. 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 seeking medical help and had just enough time to get treated before she needed to go home to get high again. She thought she still had a month remaining to find a way to become sober and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the medical facility declined to release her: the leg infection was severe, 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.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl every few hours, knowing that withdrawal could endanger 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 substance abuse treatment.
After five days, on 12 November 2022, Stephanie had a infant weighing just over four pounds – premature, little but surviving.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “not now.” She was detached. Her epidural had failed, her final administration of fentanyl had been provided four hours before delivery.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had attempted sobriety several times during pregnancy, and felt awful each time she relapsed. She felt hopeless, berating herself for not being able to overcome the challenge. An obstetrician told her to “just” stop using. Even her dealer refused to sell to her when she became visibly pregnant.
“However, I failed,” she said. “I needed help.”
The pervasive expectation that her love for her baby would make her quit only led to deeper self-loathing and negative self-talk, a cause for her to return to drugs. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.
The newborn was transferred to the neonatal intensive care unit. When Stephanie at last met her, she was hooked up to monitors, so little she thought she would break her. Embracing her at last, she felt nothing. “I looked 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 call her daughter after her caregiver, after the professional who provided support to her.
Hospital staff told her about Maddie’s Place, a innovative treatment home where women and their babies are treated together, not apart.
In numerous states, where a baby is diagnosed with neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs and medicated while their mothers face custody evaluations. But a limited but expanding group of centers like this facility is demonstrating a key fact: when parents and infants remain united, recovery succeeds, foster placements fall and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she ultimately reached out. After verifying her eligibility for the program, care providers came to pick her up.
She stepped out of the hospital still in detox, fearful and unsure about what would happen next.
At Maddie’s Place, Stephanie still feared that authorities would come remove her daughter – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could enter and separate them.
For the initial fortnight, Stephanie kept to herself. “I avoided interaction,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about enduring. Substances came first; trust came last.
Stephanie had a single companion, but even that connection was tenuous. The individuals she cared for always found ways to hurt her. She was unable to value herself, not to mention anyone else.
Every day, staff from the facility took her to a treatment center, given as medication. Over time, she was beginning recovery.
She utilized each moment beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating 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 typical problems 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.
On a day prior to the holiday, Stephanie was in the common room, where those still using can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, visited with her own five kids in tow to deliver baked goods. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The young ones stared in awe of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She holds a picture of the moment. She is dressed in casual attire, a beanie with a decoration on her head, seated on the ground with the entryway at her back. She is thin. 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 crowding near, fawning and reaching out 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 given the chance.
“In the future,” Jacob said, “I will excel as a father. I will teach them about love.”
Stephanie and her companion looked at each other. “I broke down,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I was able. I could parent.”
Approaches for managing babies with exposure have been available for years.
The assessment tool was established in 1975|