She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Saved Them Both.
In her eighth month of pregnancy and suffering, the expectant mother arrived at the ER after her infection worsened up her legs. Unemployed and homeless, estranged from her family, 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 threw up.
Stephanie ultimately gave in. “I need to leave. I have to go home and get high.”
She had used fentanyl 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 four weeks left to find a way to become sober and give birth.
The nurse had other ideas. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was severe, but doctors had discovered she also had an ruptured membrane. 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 controlled doses of fentanyl every few hours, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be switched to methadone, a drug that alleviates cravings and is commonly used in rehabilitation.
Five days later, on the 12th of November, Stephanie gave birth to a infant weighing 4lb 8oz – born before term, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was emotionless. Her epidural had failed, her previous intake of fentanyl had been provided four hours before delivery.
She felt sick. Not ready for motherhood. Undeserving.
Stephanie had tried to get clean several times during pregnancy, and felt terrible each time she was unsuccessful. She felt hopeless, criticizing herself for not being able to do the impossible. An doctor told her to “simply” stop using. Even her dealer declined to supply to her when she became obviously with child.
“Yet I was unable,” she said. “I had to seek support.”
The common assumption that her love for her baby would make her recover only led to greater shame and negative self-talk, a trigger for her to relapse. Yet she could not just wish her addiction away, any more than she could will away a long-term illness.
The baby was taken to the NICU. When Stephanie at last met her, she was attached to tubes and leads, so little she thought she would harm her. Cradling her initially, she felt nothing. “I looked at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
After two days she decided to call her daughter Izzie, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a new kind of care center where mothers and their drug-exposed newborns are treated together, not apart.
In numerous states, where a baby is diagnosed with newborn addiction symptoms every 18 minutes, infants are still whisked to NICUs and given drugs while their mothers face custody evaluations. But a small, growing network of centers like this facility is showing an important truth: 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 finally did. After confirming she would be a good fit for the program, a couple of employees came to pick her up.
She departed the institution still in detox, anxious and doubtful about what would follow.
At the care center, Stephanie still feared that CPS would come remove her daughter – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could walk in and remove her child.
For the initial fortnight, Stephanie stayed withdrawn. “I avoided interaction,” she said. “I lacked confidence at that point.”
Life on the streets, she said, was about survival. Addiction came first; reliance came last.
Stephanie had a single companion, but even that connection was tenuous. The those close to her always found ways to let her down. She did not know how to value herself, much less anyone else.
Daily, staff from the facility drove her to a treatment center, administered in pill form. Over time, she was beginning recovery.
She utilized each moment when not in sessions with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and severe digestive problems. She needed nutritional guidance. She also had heightened sensory issues and required an occupational therapist – all frequent conditions 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.
On a day prior to the holiday, Stephanie remained in the shared space, where those still using can come for monitored interactions with their babies. A support specialist, a recovery coach, came over with her own five kids 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 small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. Such issues were irrelevant.”
She has an image of the moment. She is dressed in dark trousers and a sweatshirt, a gray knit hat with a pompom on her head, sitting on the wooden floor with the exit nearby. She is thin. Her head is tilted forward so you miss her features. She is holding Izzie up on her lap for the young ones to see and they are crowding near, fawning and reaching out to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The women attempted to clarify that the men were occupied, engaged elsewhere, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion looked at each other. “I became emotional,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I would become a mother.”
Methods to address infants affected by substances have existed for decades.
The assessment tool was created in 1975|
