She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
In her eighth month of pregnancy and suffering, the expectant mother visited the medical facility after a serious infection started to spread up her legs. Without a job or home, separated from loved ones, she resided in a small structure she had built in a friend’s yard. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. The onset of withdrawal began. She slumped forward and vomited.
Stephanie eventually collapsed. “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 only a brief window to get treated before she needed to go home to relapse. She thought she still had four weeks left to figure out how to get clean and give birth.
The nurse had other ideas. She told Stephanie she was not allowed to leave.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the leg infection was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be placed on methadone, a treatment that reduces symptoms and is commonly used in substance abuse treatment.
After five days, on a day in November 2022, Stephanie delivered a baby girl weighing a small weight – early, little but surviving.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “not now.” She was detached. Her pain relief did not work, her final administration of fentanyl had been provided four hours before delivery.
She felt unwell. Not ready for motherhood. Not fit.
Stephanie had sought recovery multiple times while expecting, and felt terrible each time she was unsuccessful. She felt without value, berating herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her dealer would not provide to her when she became obviously with child.
“However, I failed,” she said. “I required assistance.”
The widespread belief that her bond with her newborn would make her quit only led to greater shame 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 eliminate a persistent condition.
The baby was taken to the NICU. When Stephanie eventually visited her, she was hooked up to monitors, so little she thought she would harm her. Embracing her at last, she felt nothing. “I just stared at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to name her baby after her caregiver, after the nurse who had been so kind to her.
Hospital staff told her about a specialized facility, a innovative treatment home where women and their babies are cared for jointly, not apart.
In much of the US, where a baby is identified with newborn addiction symptoms every 18 minutes, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face custody evaluations. But a developing system of centers like the care home is demonstrating a key fact: when families are kept intact, recovery succeeds, foster placements fall and long-term costs decline.
It took Stephanie some time to build confidence to call, but she ultimately reached out. After verifying her eligibility for the program, two staff members came to bring her to the facility.
She left the medical center still in detox, fearful and unsure about what would follow.
At Maddie’s Place, Stephanie still feared 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 arrive and separate them.
For the first two weeks, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about getting by. Substances came first; reliance came last.
Stephanie had a trusted ally, but even that connection was tenuous. The those close to her always found ways to hurt her. She lacked the ability to care for herself, let alone anyone else.
Every day, staff from the center transported her to a treatment center, given as medication. Gradually, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was receiving appropriate attention she needed. Her daughter struggled with eating at first, with adverse reactions to milk and obvious stomach troubles. She needed feeding therapy. She also had heightened sensory issues 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 found the strength. I would become a mother.
One afternoon before Thanksgiving, Stephanie remained in the shared space, where parents in active addiction can come for guided meetings with their babies. Katie Bunch-Smith, a mentor, came over with her own family in tow to drop off cookies. They all crowded near Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in wonder of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. None of those things mattered to them.”
She has an image of the moment. She is wearing dark trousers and a sweatshirt, a beanie with a bobble on her head, sitting on the wooden floor with the exit nearby. She is slender. Her head is tilted forward so you do not see her expression. She is presenting her daughter on her leg for the young ones to see and they are standing close, showing interest to the baby.
One child, eight, asked the parents: “What about the fathers?” The parents responded that the dads were busy, handling responsibilities, that they would be there if possible.
“Once I become a parent,” Jacob said, “I will excel as a father. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist exchanged glances. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I could do this. I could be a mom.”
Approaches for managing infants affected by substances have been available for years.
The evaluation method was established in 1975|
