She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
Pregnant and experiencing intense discomfort, the expectant mother went to 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 assembled in a acquaintance's garden. She was also dependent on fentanyl.
As physicians addressed her infection, she began to panic. The onset of withdrawal began. She slumped forward and threw up.
Stephanie finally broke down. “Listen, I gotta go. I have to go home and use drugs.”
She had taken the drug before coming to the ER and had just enough time to get treated before she had to return to use once more. She thought she still had four weeks left to find a way to become sober and have this baby.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge 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 walked out, she and her baby would face grave danger.
She encouraged the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be placed on methadone, a drug that alleviates cravings and is frequently utilized in addiction recovery.
After five days, on 12 November 2022, Stephanie had a infant weighing 4lb 8oz – early, tiny yet healthy.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “not now.” She was emotionless. Her anesthesia was ineffective, her final administration of fentanyl had been provided shortly before she gave birth.
She felt ill. Unprepared to be a mother. Undeserving.
Stephanie had tried to get clean several times during pregnancy, and felt terrible each time she failed. She felt without value, blaming herself for not being able to overcome the challenge. An OBGYN told her to “just” stop using. Even her source refused to sell to her when she became obviously with child.
“However, I failed,” she said. “I required assistance.”
The widespread belief that her love for her baby would make her stop using only led to increased guilt and self-harm, a trigger for her to use again. Yet she could not easily command her addiction away, any more than she could overcome a chronic disease.
The newborn was transferred to the NICU. When Stephanie at last met her, she was attached to monitors, so little she thought she would harm her. Embracing her at last, she felt detached. “I just stared at her and was like, ‘What is our future?’” She remained uncertain she wanted to be her mother.
Following a brief period 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 new kind of care center where parents and infants affected by substance use are cared for jointly, not apart.
In many parts of America, where a baby is identified with newborn addiction symptoms regularly, infants are still quickly moved to hospitals and medicated while their mothers face child-protection investigations. But a limited but expanding group of centers like Maddie’s Place is proving a simple point: when mothers and babies stay together, results get better, custody cases decrease and long-term costs decline.
It took Stephanie some time to build confidence to call, but she eventually made the call. After confirming she would be a good fit for the program, a couple of employees came to collect her.
She left the medical center still in recovery, anxious and doubtful about what would come next.
At the facility, Stephanie still worried that authorities would come take Izzie – even though she was hesitant about parenting. The anxiety remained: that at any moment, someone could enter and separate them.
For the first two weeks, Stephanie remained isolated. “I avoided interaction,” 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 bond was fragile. The people she loved always found ways to let her down. She lacked the ability to care for herself, much less anyone else.
Every day, staff from Maddie’s Place transported her to a treatment center, given as medication. Gradually, she was starting to get clean.
She devoted all her time 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 intolerance to some formulas and severe digestive problems. She needed dietary support. She also had increased sensitivity and required an specialist – all common issues for babies exposed to substances.
When a child recognizes these infants need affection, then I was capable. I would become a mother.
On a day prior to the holiday, Stephanie remained in the shared space, where parents in active addiction can come for guided meetings with their babies. An advocate, a peer support specialist, visited with her own family in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The children were wide-eyed in wonder of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She holds a picture of the moment. She is dressed in dark trousers and a sweatshirt, a cap with a pompom on her head, seated on the ground with the entryway at her back. She is slender. Her head is tilted forward so you cannot see her face. She is holding Izzie up on her lap for the children to see and they are crowding near, showing interest to the baby.
One child, eight, asked the moms: “Why are there no men?” The moms tried to explain 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. They will know they are valued.”
Stephanie and Bunch-Smith exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I could parent.”
Approaches for managing drug-exposed newborns have been available for years.
The assessment tool was established in 1975|
