A Pregnant Woman's Battle with Fentanyl Addiction: The Decision to Keep Her Child Rescued Both Lives.
Eight months pregnant and in severe pain, the expectant mother went to the medical facility after an infection began spreading up her legs. Without a job or home, cut off from her relatives, she resided in a small structure she had constructed in a acquaintance's garden. She was also addicted to fentanyl.
As doctors treated her infection, she started to feel anxious. The onset of withdrawal began. She bent over the bedside and vomited.
Stephanie ultimately gave in. “Listen, I gotta go. I have to go home and take a hit.”
She had consumed opioids before arriving at the hospital and had just enough time to get treated before she had to return to get high again. She thought she still had several weeks to find a way to become sober and have this baby.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“I am leaving,” Stephanie said.
But the hospital refused to discharge her: the leg infection was severe, but physicians found she also had an ruptured membrane. 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 symptoms could threaten her and the baby. Post-birth Stephanie would be switched to methadone, a drug that alleviates cravings and is commonly used in rehabilitation.
Five days later, on the 12th of November, Stephanie delivered a daughter weighing just over four pounds – early, small but alive.
When the attendant inquired if she wanted to cuddle her newborn, Stephanie said “no.” She was detached. Her epidural had failed, her last dose of fentanyl had been administered four hours before delivery.
She felt unwell. Not ready for motherhood. Unworthy.
Stephanie had tried to get clean repeatedly before birth, and felt horrible each time she relapsed. She felt without value, blaming herself for not being able to overcome the challenge. An obstetrician told her to “just” stop using. Even her dealer declined to supply to her when she became visibly pregnant.
“Yet I was unable,” she said. “I required assistance.”
The common assumption that her love for her baby would make her quit only led to greater shame and self-harm, a impetus for her to return to drugs. Yet she could not just wish her addiction away, any more than she could will away a chronic disease.
The infant was moved to the neonatal intensive care unit. When Stephanie at last met her, she was connected to monitors, so tiny she thought she would break her. Cradling her initially, she felt nothing. “I gazed upon 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 call her daughter after her caregiver, after the nurse who had been so kind to her.
Hospital staff told her about a care center, a new kind of care center where mothers and their drug-exposed newborns are cared for jointly, not apart.
In many parts of America, where a baby is found to have neonatal abstinence syndrome (NAS) frequently, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a developing system of centers like Maddie’s Place is demonstrating a key fact: when families are kept intact, recovery succeeds, fewer children enter care and overall savings increase.
It took Stephanie a while to gather the courage to call, but she finally did. After ensuring she qualified for the program, care providers came to bring her to the facility.
She stepped out of the hospital still in detox, fearful and unsure about what would follow.
At the facility, Stephanie still feared that CPS would come seize her child – even though she was hesitant about parenting. The anxiety remained: that at any point, someone could walk in and remove her child.
For the initial fortnight, Stephanie remained isolated. “I preferred to be alone,” she said. “I didn’t have a lot of trust at that point.”
Homelessness, she said, was about enduring. Substances came first; trust came last.
Stephanie had one close friend, but even that connection was tenuous. The individuals she cared for always found ways to hurt her. She lacked the ability to love herself, much less anyone else.
Every day, staff from Maddie’s Place drove her to a recovery program, administered in pill form. Slowly, she was embracing sobriety.
She spent every minute beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her infant faced feeding challenges at first, with sensitivity to certain foods and obvious stomach troubles. She needed feeding therapy. She also had sensory challenges 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 was capable. I could be a mom.
During a pre-holiday visit, Stephanie remained in the shared space, where parents in active addiction can come for monitored interactions with their babies. An advocate, a peer support specialist, visited with her own family in tow to drop off cookies. They all assembled beside Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in admiration of the tiny infant in Stephanie’s arms. “They had no care in the world,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She keeps a photo of the moment. She is clad in dark trousers and a sweatshirt, a gray knit hat with a pompom on her head, seated on the ground with the exit nearby. She is lean. Her head is tilted forward so you do not see her expression. She is holding Izzie up on her lap for the children to see and they are standing close, admiring and touching to the baby.
A young boy, eight, asked the mothers: “Where are all the dads?” The parents responded that the men were occupied, engaged elsewhere, that they would be there if possible.
“When I have kids,” Jacob said, “I’m going to be the best dad ever. I’m gonna show them that they deserve to be loved.”
Stephanie and Bunch-Smith exchanged glances. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I was able. I could parent.”
Approaches for managing drug-exposed newborns have been used for a long time.
The evaluation method was established in 1975|
