She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Rescued Both Lives.
Pregnant and experiencing intense discomfort, a woman named Stephanie went to the ER after a serious infection started to spread up her legs. Unemployed and homeless, cut off from her relatives, she lived in a shed she had constructed in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and vomited.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and use drugs.”
She had used fentanyl before coming to the ER and had sufficient opportunity to get treated before she needed to go home to get high again. She thought she still had several weeks to figure out how to get clean and have this baby.
The nurse had other ideas. She told Stephanie she was staying put.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was serious, but doctors had discovered she also had an ruptured membrane. The nurse, a caregiver named Izzie, warned her: if she left, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Once the baby was born Stephanie would be placed on methadone, a drug that alleviates cravings and is often prescribed in rehabilitation.
After five days, on 12 November 2022, Stephanie delivered a infant weighing 4lb 8oz – born before term, tiny yet healthy.
When the caregiver questioned if she wanted to cuddle her newborn, Stephanie said “no.” She was numb. Her anesthesia was ineffective, her final administration of fentanyl had been given a few hours prior to birth.
She felt ill. Unprepared to be a mother. Undeserving.
Stephanie had sought recovery several times during pregnancy, and felt terrible each time she was unsuccessful. She felt without value, criticizing herself for not being able to do the impossible. An OBGYN told her to “only” stop using. Even her supplier refused to sell to her when she became visibly pregnant.
“But I couldn’t,” she said. “I needed help.”
The widespread belief that her affection for her child would make her stop using only led to deeper self-loathing and self-harm, a trigger for her to relapse. Yet she could not easily command her addiction away, any more than she could will away a persistent condition.
The baby was taken to the special care nursery. When Stephanie eventually visited her, she was connected to monitors, so tiny she thought she would break her. Cradling her initially, she felt nothing. “I just stared at her and was like, ‘What is our future?’” She continued to doubt she wanted to be her mother.
Two days later she decided to give her child the name Izzie, after the nurse who had been so kind to her.
Hospital staff told her about a specialized facility, a unique recovery environment where women and their babies are treated together, not apart.
In numerous states, where a baby is found to have infant withdrawal condition regularly, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face child-protection investigations. But a developing system of centers like Maddie’s Place is showing an important truth: when parents and infants remain united, outcomes improve, foster placements fall and future expenses reduce.
It took Stephanie some time to build confidence to call, but she finally did. After confirming she would be a good fit for the program, a couple of employees came to bring her to the facility.
She stepped out of the hospital still in withdrawal, fearful and unsure about what would follow.
At the care center, Stephanie still was concerned that child services would come take Izzie – even though she was hesitant about parenting. The fear lingered: that at any moment, someone could arrive and remove her child.
For the beginning period, Stephanie kept to herself. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about survival. Addiction came first; reliance came last.
Stephanie had one close friend, but even that connection was tenuous. The people she loved always found ways to let her down. She was unable to love herself, much less anyone else.
Daily, staff from the facility took her to a recovery program, provided orally. Over time, she was beginning recovery.
She devoted all her time beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with intolerance to some formulas and severe digestive problems. She needed dietary support. She also had heightened sensory issues and required an specialist – all common issues for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I was capable. I could parent.
On a day prior to the holiday, Stephanie was in the common room, where individuals struggling with substance use can come for supervised visits with their babies. A support specialist, a peer support specialist, stopped by with her own family in tow to drop off cookies. They all gathered around Stephanie, who was resting on the carpet holding Izzie.
The kids looked amazed in wonder of the little newborn in Stephanie’s arms. “They showed no judgment,” Stephanie said. “They overlooked my addiction. They focused only on the baby.”
She keeps a photo of the moment. She is clad in casual attire, a cap with a decoration on her head, resting on the floor with the exit nearby. She is thin. Her face is downcast so you cannot see her face. She is presenting her daughter on her knee for the other kids to see and they are gathered around, admiring and touching to the baby.
Jacob, eight, asked the moms: “Where are all the dads?” The parents responded that the dads were busy, engaged elsewhere, that they would be there given the chance.
“In the future,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and the specialist made eye contact. “I became emotional,” Stephanie said. “When a child recognized that infants need affection, then I found the courage. I could be a mom.”
Approaches for managing infants affected by substances have existed for decades.
The assessment tool was created in 1975|
