She Was Pregnant and Addicted to Fentanyl: Choosing Motherhood Saved Them Both.
Eight months pregnant and in severe pain, a woman named Stephanie arrived at the medical facility after a serious infection started to spread up her legs. Without a job or home, cut off from her relatives, she lived in a shed she had constructed in a friend’s yard. She was also addicted to fentanyl.
As physicians addressed her infection, she began to panic. Withdrawal was setting in. She slumped forward and threw up.
Stephanie finally broke down. “Listen, I gotta go. 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 relapse. She thought she still had a month remaining to find a way to become sober and give birth.
The attending nurse disagreed. She told Stephanie she was staying put.
“I am leaving,” Stephanie said.
But the doctors would not let her go: the leg infection was critical, but medical staff detected she also had an leakage of amniotic fluid. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. After delivery Stephanie would be switched to methadone, a treatment that reduces symptoms and is frequently utilized in rehabilitation.
Five days later, on 12 November 2022, Stephanie gave birth to a infant weighing just over four pounds – early, tiny yet healthy.
When the caregiver questioned if she wanted to hold her baby, Stephanie said “no.” She was emotionless. Her pain relief did not work, her final administration of fentanyl had been provided shortly before she gave birth.
She felt unwell. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt horrible each time she was unsuccessful. She felt hopeless, berating herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her source declined to supply to her when she became visibly pregnant.
“But I couldn’t,” she said. “I had to seek support.”
The widespread belief that her bond with her newborn would make her stop using only led to deeper self-loathing and self-harm, a cause for her to return to drugs. Yet she could not just wish her addiction away, any more than she could will away a long-term illness.
The newborn was transferred to the NICU. When Stephanie finally saw her her, she was hooked up to monitors, so tiny she thought she would hurt her. Cradling her initially, she felt empty. “I looked at her and was like, ‘How will I care for you?’” She continued to doubt she wanted to be her mother.
After two days she decided to call her daughter Izzie, after the attendant who showed compassion to her.
Medical personnel told her about Maddie’s Place, a unique recovery environment where parents and infants affected by substance use are supported as a unit, not apart.
In much of the US, where a baby is found to have newborn addiction symptoms frequently, infants are still quickly moved to hospitals and given drugs while their mothers face child-protection investigations. But a limited but expanding group of centers like this facility is demonstrating a key fact: when mothers and babies stay together, outcomes improve, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength to call, but she finally did. After confirming she would be a good fit for the program, two staff members came to bring her to the facility.
She stepped out of the hospital still in withdrawal, scared and uncertain about what would come next.
At the facility, Stephanie still worried that CPS would come seize her child – even though she was hesitant about parenting. The anxiety remained: that at any time, someone could walk in and separate them.
For the initial fortnight, Stephanie remained isolated. “I avoided interaction,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about survival. Addiction came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to hurt her. She lacked the ability to value herself, much less anyone else.
Every day, staff from the facility drove her to a treatment center, administered in pill form. Gradually, she was beginning recovery.
She devoted all her time when not in sessions with Izzie, and could see that her baby was receiving appropriate attention she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and obvious stomach troubles. She needed nutritional guidance. She also had heightened sensory issues and required an specialist – all typical problems for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I could do this. I could be a mom.
On a day prior to the holiday, Stephanie was in the common room, where parents in active addiction can come for monitored interactions with their babies. An advocate, a mentor, stopped by with her own five kids in tow to drop off cookies. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The children were wide-eyed in wonder of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a gray knit hat with a decoration on her head, sitting on the wooden floor with the exit nearby. She is slender. Her face is downcast so you cannot see her face. She is presenting her daughter on her leg for the children to see and they are standing close, showing interest to the baby.
One child, eight, asked the parents: “Where are all the dads?” The moms tried to explain that the men were occupied, handling responsibilities, that they would be there if possible.
“In the future,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and the specialist looked at each other. “I became emotional,” Stephanie said. “If this little kid could see that infants need affection, then I could do this. I would become a mother.”
Methods to address infants affected by substances have been used for a long time.
The assessment tool was established in 1975|
