She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
In her eighth month of pregnancy and suffering, the expectant mother arrived at the medical facility after a serious infection started to spread up her legs. Without a job or home, estranged from her family, she resided in a small structure she had constructed in a acquaintance's garden. She was also hooked on fentanyl.
As physicians addressed her infection, she grew increasingly fearful. Withdrawal was setting in. She slumped forward and threw up.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and get high.”
She had taken the drug before coming to the ER and had only a brief window to get treated before she needed to go home to use once more. She thought she still had a month remaining to plan her recovery and deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was critical, but doctors had discovered she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would be at risk of death.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be transitioned to methadone, a medication that eases withdrawal and is frequently utilized in substance abuse treatment.
After five days, on the 12th of November, Stephanie delivered a infant weighing 4lb 8oz – premature, tiny yet healthy.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “no.” She was detached. Her epidural had failed, her last dose of fentanyl had been given four hours before delivery.
She felt ill. Ill-equipped for parenting. Undeserving.
Stephanie had tried to get clean multiple times while expecting, and felt horrible each time she failed. She felt worthless, blaming herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her source refused to sell to her when she became obviously with child.
“However, I failed,” she said. “I had to seek support.”
The common assumption that her bond with her newborn would make her recover only led to increased guilt and self-harm, a trigger for her to relapse. Yet she could not easily command 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 tiny she thought she would harm her. Embracing her at last, she felt nothing. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to call her daughter the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about a specialized facility, a new kind of care center where parents and infants affected by substance use are supported as a unit, not apart.
In much of the US, where a baby is diagnosed with infant withdrawal condition frequently, infants are still rushed to special care and medicated while their mothers face child-protection investigations. But a developing system of centers like Maddie’s Place is demonstrating a key fact: when families are kept intact, recovery succeeds, foster placements fall and overall savings increase.
It took Stephanie a period to find strength to call, but she ultimately reached out. After ensuring she qualified for the program, care providers came to collect her.
She stepped out of the hospital still in recovery, anxious and doubtful about what would follow.
At Maddie’s Place, Stephanie still worried that child services would come seize her child – even though she was not sure she wanted to keep her. The fear lingered: that at any moment, someone could enter and take her baby away.
For the initial fortnight, Stephanie remained isolated. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Survival outdoors, she said, was about survival. Drugs came first; trust came last.
Stephanie had one close friend, but even that relationship was delicate. The individuals she cared for always found ways to let her down. She lacked the ability to value herself, not to mention anyone else.
Every day, staff from the center transported her to a recovery program, administered in pill form. Over time, she was starting to get clean.
She spent every minute beyond therapy with Izzie, and could see that her baby was getting the specialized care 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 sensory challenges and required an occupational therapist – all frequent conditions for babies exposed to substances.
When a child recognizes these infants need affection, then I found the strength. I could parent.
During a pre-holiday visit, Stephanie remained in the shared space, where individuals struggling with substance use can come for guided meetings with their babies. An advocate, a peer support specialist, came over with her own children in tow to drop off cookies. They all crowded near Stephanie, who was seated on the ground holding Izzie.
The children were wide-eyed in awe of the small baby in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She keeps a photo of the moment. She is clad in casual attire, a cap with a bobble on her head, resting on the floor with the door behind her. She is lean. Her head is tilted forward so you cannot see her face. She is presenting her daughter on her knee for the young ones to see and they are crowding near, fawning and reaching out to the baby.
Jacob, eight, asked the parents: “Where are all the dads?” The women attempted to clarify that the men were occupied, called away to other tasks, 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 looked at each other. “I broke down,” Stephanie said. “When a child recognized that infants need affection, then I was able. I would become a mother.”
Tools for treating infants affected by substances have been available for years.
The evaluation method was developed in 1975|
