She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, a woman named Stephanie visited the medical facility after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she lived in a shed she had built in a friend’s yard. She was also hooked on fentanyl.
As medical staff managed her infection, she began to panic. Symptoms of withdrawal emerged. She leaned over the bed 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 seeking medical help and had just enough time to get treated before she needed to go home to use once more. She thought she still had a month remaining to figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the leg infection was critical, but doctors had discovered she also had an amniotic fluid leak. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a medication that eases withdrawal and is commonly used in substance abuse treatment.
A short time later, on 12 November 2022, Stephanie gave birth to a infant weighing a small weight – born before term, small but alive.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been administered shortly before she gave birth.
She felt ill. Unprepared to be a mother. Unworthy.
Stephanie had tried to get clean repeatedly before birth, and felt awful each time she relapsed. She felt worthless, berating herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her supplier declined to supply to her when she became visibly pregnant.
“However, I failed,” she said. “I had to seek support.”
The widespread belief that her affection for her child would make her stop using only led to greater shame and negative self-talk, a trigger for her to return to drugs. Yet she could not easily command her addiction away, any more than she could eliminate a chronic disease.
The newborn was transferred to the special care nursery. When Stephanie eventually visited her, she was hooked up to tubes and leads, so tiny she thought she would break her. Holding her for the first time, she felt nothing. “I just stared at her and was like, ‘What is our future?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to call her daughter after her caregiver, after the nurse who had been so kind to her.
Nurses and doctors told her about a care center, a innovative treatment home where women and their babies are cared for jointly, not apart.
In numerous states, where a baby is found to have newborn addiction symptoms regularly, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a small, growing network of centers like Maddie’s Place is proving a simple point: when parents and infants remain united, results get better, foster placements fall and long-term costs decline.
It took Stephanie some time to build confidence to call, but she eventually made the call. After ensuring she qualified for the program, a couple of employees came to pick her up.
She stepped out of the hospital still in recovery, fearful and unsure about what would happen next.
At the care center, Stephanie still worried that CPS would come take Izzie – even though she was uncertain about motherhood. The fear lingered: that at any point, someone could enter and take her baby away.
For the first two weeks, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about enduring. Substances 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 lacked the ability to love herself, let alone anyone else.
Each day, staff from the center drove her to a recovery program, administered in pill form. Slowly, she was beginning recovery.
She utilized each moment outside treatment with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and severe digestive problems. She needed feeding therapy. She also had sensory challenges and required an occupational therapist – all frequent conditions for babies born with NAS.
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 was in the common room, where those still using can come for supervised visits with their babies. Katie Bunch-Smith, a peer support specialist, stopped by with her own family in tow to deliver baked goods. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in admiration of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She has an image of the moment. She is wearing dark trousers and a sweatshirt, a gray knit hat with a pompom on her head, seated on the ground with the exit nearby. She is slender. Her face is downcast so you do not see her expression. 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.
Jacob, eight, asked the mothers: “Where are all the dads?” The parents responded that the men were occupied, called away to other tasks, that they would be there if they could.
“In the future,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith made eye contact. “I became emotional,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I could be a mom.”
Approaches for managing babies with exposure have been available for years.
The Finnegan NAS scale was established in 1975|