A Pregnant Woman's Battle with Fentanyl Addiction: How Keeping Her Baby Saved Them Both.
Eight months pregnant and in severe pain, the expectant mother arrived at the ER after her infection worsened up her legs. Unemployed and homeless, separated from loved ones, she resided in a small structure she had built in a acquaintance's garden. She was also addicted to fentanyl.
As doctors treated her infection, she began to panic. Symptoms of withdrawal emerged. She bent over the bedside and became sick.
Stephanie eventually collapsed. “Listen, I gotta go. I have to go home and get high.”
She had used fentanyl before coming to the ER and had just enough time to get treated before she was compelled to leave to get high again. She thought she still had a month remaining to plan her recovery and deliver her child.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the doctors would not let her go: the infection in her legs was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, a caregiver named Izzie, warned her: if she walked out, she and her baby would not survive.
The nurse convinced the doctor to give Stephanie regulated amounts of fentanyl periodically, knowing that abstinence might harm her and the baby. Once the baby was born Stephanie would be transitioned to methadone, a medication that eases withdrawal and is commonly used in addiction recovery.
A short time later, on a day in November 2022, Stephanie had a baby girl weighing a small weight – premature, little but surviving.
When the caregiver questioned if she wanted to embrace her child, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been given a few hours prior to birth.
She felt sick. Unprepared to be a mother. Undeserving.
Stephanie had tried to get clean repeatedly before birth, and felt awful each time she failed. She felt worthless, berating herself for not being able to do the impossible. An OBGYN told her to “simply” stop using. Even her source declined to supply to her when she became obviously with child.
“However, I failed,” she said. “I had to seek support.”
The pervasive expectation that her love for her baby would make her quit only led to greater shame and self-harm, a impetus for her to relapse. Yet she could not just wish her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the neonatal intensive care unit. When Stephanie eventually visited her, she was attached to tubes and leads, so tiny she thought she would harm her. Holding her for the first time, she felt empty. “I just stared at her and was like, ‘How will I care for you?’” She still wasn’t sure she wanted to be her mother.
After two days she decided to name her baby Izzie, after the nurse who had been so kind to her.
Medical personnel told her about Maddie’s Place, a new kind of care center where mothers and their drug-exposed newborns are supported as a unit, not apart.
In numerous states, where a baby is identified with neonatal abstinence syndrome (NAS) regularly, infants are still whisked to NICUs and treated with pharmaceuticals while their mothers face custody evaluations. But a small, growing network of centers like this facility is proving a simple point: when parents and infants remain united, recovery succeeds, fewer children enter care and future expenses reduce.
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, two staff members came to pick her up.
She left the medical center still in detox, anxious and doubtful about what would follow.
At the care center, Stephanie still was concerned that CPS would come remove her daughter – even though she was uncertain about motherhood. The fear lingered: that at any time, someone could arrive and remove her child.
For the initial fortnight, Stephanie stayed withdrawn. “I didn’t really want anything to do with any of them,” she said. “I didn’t have a lot of trust at that point.”
Survival outdoors, she said, was about survival. Substances came first; trust came last.
Stephanie had a single companion, but even that bond was fragile. The those close to her always found ways to cause pain. She did not know how to care for herself, not to mention anyone else.
Daily, staff from Maddie’s Place drove her to a clinic for methadone, provided orally. Over time, she was embracing sobriety.
She utilized each moment when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with sensitivity to certain foods and obvious stomach troubles. She needed dietary support. She also had heightened sensory issues and required an occupational therapist – all frequent conditions for babies exposed to substances.
Seeing that even a young person understands the need for care, then I could do this. I could be a mom.
During a pre-holiday visit, Stephanie sat in the visitation area, where parents in active addiction can come for guided meetings with their babies. A support specialist, a recovery coach, stopped by with her own five kids in tow to bring treats. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in awe 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 wearing black pants and a hoodie, a beanie with a decoration on her head, sitting on the wooden floor with the entryway at her back. She is thin. Her face is downcast so you cannot see her face. She is lifting the baby on her knee for the children to see and they are crowding near, showing interest to the baby.
One child, eight, asked the parents: “Why are there no men?” The women attempted to clarify that the men were occupied, engaged elsewhere, that they would be there if possible.
“When I have kids,” Jacob said, “I plan to be a great parent. They will know they are valued.”
Stephanie and Bunch-Smith looked at each other. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I found the courage. I could be a mom.”
Approaches for managing babies with exposure have been used for a long time.
The Finnegan NAS scale was established in 1975|
