She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Saved Them Both.
Eight months pregnant and in severe pain, the expectant mother arrived at the medical facility after her infection worsened up her legs. Jobless and without shelter, cut off from her relatives, she stayed in a makeshift shelter she had assembled in a friend’s yard. She was also dependent on fentanyl.
As medical staff managed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and became sick.
Stephanie ultimately gave in. “I have to get out of here. I have to go home and get high.”
She had consumed opioids before seeking medical help and had only a brief window to get treated before she needed to go home to use once more. She thought she still had several weeks to figure out how to get clean and have this baby.
The medical professional intervened. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was serious, 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 be at risk of death.
The nurse convinced the doctor to give Stephanie measured quantities of fentanyl at regular intervals, knowing that abstinence might harm her and the baby. Post-birth Stephanie would be transitioned to methadone, a medication that eases withdrawal and is frequently utilized in addiction recovery.
A short time later, on a day in November 2022, Stephanie delivered a infant weighing a small weight – early, small but alive.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “not now.” She was detached. Her epidural had failed, her final administration of fentanyl had been given a few hours prior to birth.
She felt ill. Not ready for motherhood. Not fit.
Stephanie had attempted sobriety multiple times while expecting, and felt terrible each time she was unsuccessful. She felt without value, criticizing herself for not being able to achieve the unattainable. An obstetrician told her to “just” stop using. Even her dealer refused to sell to her when she became clearly expecting.
“Yet I was unable,” she said. “I required assistance.”
The common assumption that her bond with her newborn would make her stop using only led to increased guilt and self-harm, a trigger for her to return to drugs. Yet she could not simply will her addiction away, any more than she could eliminate a chronic disease.
The infant was moved to the NICU. When Stephanie eventually visited her, she was hooked up to monitors, so tiny she thought she would hurt her. Cradling her initially, she felt detached. “I just stared at her and was like, ‘How will I care for you?’” She remained uncertain she wanted to be her mother.
Two days later she decided to name her baby Izzie, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a unique recovery environment where mothers and their drug-exposed newborns are cared for jointly, not apart.
In much of the US, where a baby is identified with neonatal abstinence syndrome (NAS) frequently, infants are still whisked to NICUs and medicated while their mothers face child-protection investigations. But a small, growing network of centers like Maddie’s Place is showing an important truth: when mothers and babies stay together, outcomes improve, foster placements fall and future expenses reduce.
It took Stephanie some time to build confidence to call, but she finally did. After verifying her eligibility for the program, a couple of employees came to bring her to the facility.
She departed the institution still in recovery, anxious and doubtful about what would follow.
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 moment, someone could walk in and remove her child.
For the initial fortnight, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I lacked confidence at that point.”
Homelessness, she said, was about enduring. Substances came first; faith came last.
Stephanie had a single companion, but even that bond was fragile. The people she loved always found ways to cause pain. She lacked the ability to love herself, much less anyone else.
Daily, staff from the center transported her to a recovery program, administered in pill form. Gradually, she was beginning recovery.
She devoted all her time outside treatment with Izzie, and could see that her baby was obtaining necessary support she needed. Her daughter struggled with eating at first, with adverse reactions to milk and severe digestive problems. She needed dietary support. She also had increased sensitivity and required an occupational therapist – all common issues for babies exposed to substances.
Seeing that even a young person understands the need for care, then I could do this. I would become a mother.
On a day prior to the holiday, Stephanie remained in the shared space, where those still using can come for supervised visits with their babies. A support specialist, a mentor, came over with her own five kids in tow to deliver baked goods. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in admiration of the small baby in Stephanie’s arms. “They were innocent,” Stephanie said. “They didn’t care that I had used drugs with her. They focused only on the baby.”
She holds a picture of the moment. She is clad in dark trousers and a sweatshirt, a cap with a decoration on her head, seated on the ground with the entryway at her back. She is lean. Her posture is humble so you cannot see her face. She is lifting the baby on her knee for the children to see and they are crowding near, admiring and touching to the baby.
One child, eight, asked the moms: “Where are all the dads?” The women attempted to clarify that the dads were busy, handling responsibilities, that they would be there if possible.
“In the future,” 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 broke down,” Stephanie said. “Seeing that even youth understand that infants need affection, then I was able. I could parent.”
Approaches for managing drug-exposed newborns have been used for a long time.
The assessment tool was created in 1975|
