She Was Pregnant and Addicted to Fentanyl: The Decision to Keep Her Child Rescued Both Lives.
Pregnant and experiencing intense discomfort, the expectant mother went to the ER after a serious infection started to spread up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had assembled in a companion's property. She was also dependent on fentanyl.
As physicians addressed her infection, she started to feel anxious. Symptoms of withdrawal emerged. She slumped forward and threw up.
Stephanie finally broke down. “I have to get out of here. I have to go home and take a hit.”
She had used fentanyl before arriving at the hospital and had only a brief window to get treated before she was compelled to leave to use once more. She thought she still had a month remaining to find a way to become sober and deliver her child.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the infection in her legs was critical, but doctors had discovered she also had an amniotic fluid leak. The nurse, Izzie, warned her: if she departed, she and her baby would be at risk of death.
She encouraged the doctor to give Stephanie regulated amounts of fentanyl at regular intervals, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be transitioned to methadone, a drug that alleviates cravings and is frequently utilized in rehabilitation.
After five days, on 12 November 2022, Stephanie delivered a daughter weighing just over four pounds – born before term, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “not now.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been provided four hours before delivery.
She felt unwell. Unprepared to be a mother. Not fit.
Stephanie had tried to get clean repeatedly before birth, and felt awful each time she failed. She felt hopeless, berating herself for not being able to overcome the challenge. An doctor told her to “only” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I had to seek support.”
The common assumption that her love for her baby would make her stop using only led to deeper self-loathing and negative self-talk, a cause for her to use again. Yet she could not just wish her addiction away, any more than she could overcome a chronic disease.
The newborn was transferred to the neonatal intensive care unit. When Stephanie finally saw her her, she was hooked up to medical equipment, so little she thought she would harm her. Holding her for the first time, she felt empty. “I looked at her and was like, ‘What am I going to do with you?’” She remained uncertain she wanted to be her mother.
Following a brief period she decided to name her baby Izzie, after the professional who provided support to her.
Medical personnel told her about Maddie’s Place, a innovative treatment home where parents and infants affected by substance use are supported as a unit, not apart.
In much of the US, where a baby is diagnosed with newborn addiction symptoms frequently, infants are still rushed to special care and medicated while their mothers face parental assessments. But a limited but expanding group of centers like this facility is showing an important truth: when parents and infants remain united, results get better, custody cases decrease and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to pick her up.
She left the medical center still in recovery, fearful and unsure about what would follow.
At the facility, Stephanie still was concerned that child services would come remove her daughter – even though she was not sure she wanted to keep her. The anxiety remained: that at any moment, someone could arrive and separate them.
For the first two weeks, Stephanie kept to herself. “I didn’t really want anything to do with any of them,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about survival. Substances came first; faith came last.
Stephanie had a single companion, but even that relationship was delicate. The people she loved always found ways to let her down. She was unable to care for herself, not to mention anyone else.
Each day, staff from the center transported her to a clinic for methadone, administered in pill form. Gradually, she was starting to get clean.
She devoted all her time beyond therapy with Izzie, and could see that her baby was getting the specialized care 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 professional – all frequent conditions for babies born with NAS.
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 was in the common room, where individuals struggling with substance use can come for guided meetings with their babies. A support specialist, a recovery coach, stopped by with her own children in tow to bring treats. They all assembled beside Stephanie, who was seated on the ground holding Izzie.
The young ones stared in admiration of the small baby in Stephanie’s arms. “They showed no judgment,” Stephanie said. “My past did not matter to them. They focused only on the baby.”
She keeps a photo of the moment. She is dressed in dark trousers and a sweatshirt, a gray knit hat with a bobble on her head, resting on the floor with the entryway at her back. She is slender. Her head is tilted forward so you miss her features. She is holding Izzie up on her knee for the children to see and they are standing close, fawning and reaching out to the baby.
One child, eight, asked the parents: “Why are there no men?” 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. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith made eye contact. “I broke down,” Stephanie said. “When a child recognized that these babies deserve to be loved, then I could do this. I could be a mom.”
Tools for treating babies with exposure have existed for decades.
The Finnegan NAS scale was established in 1975|
