She Was Pregnant and Addicted to Fentanyl: How Keeping Her Baby Transformed Their Futures.
In her eighth month of pregnancy and suffering, a woman named Stephanie went to the hospital emergency room after an infection began spreading up her legs. Without a job or home, estranged from her family, she lived in a shed she had built in a friend’s yard. She was also dependent on fentanyl.
As doctors treated her infection, she grew increasingly fearful. The onset of withdrawal began. She bent over the bedside and became sick.
Stephanie ultimately gave in. “I need to leave. I have to go home and take a hit.”
She had consumed opioids before seeking medical help and had just enough time to get treated before she had to return to use once more. She thought she still had four weeks left to figure out how to get clean and deliver her child.
The nurse had other ideas. She told Stephanie she was not going anywhere.
“Yes, I am,” Stephanie said.
But the hospital refused to discharge her: the condition in her limbs was serious, but medical staff detected she also had an amniotic fluid leak. The nurse, 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 every few hours, knowing that symptoms could threaten her and the baby. After delivery Stephanie would be placed on methadone, a treatment that reduces symptoms and is commonly used in addiction recovery.
Five days later, on a day in November 2022, Stephanie had a daughter weighing 4lb 8oz – premature, tiny yet healthy.
When the nurse asked if she wanted to cuddle her newborn, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her previous intake of fentanyl had been given shortly before she gave birth.
She felt sick. Unprepared to be a mother. Unworthy.
Stephanie had attempted sobriety multiple times while expecting, and felt awful each time she failed. She felt without value, criticizing herself for not being able to achieve the unattainable. An OBGYN told her to “only” stop using. Even her dealer declined to supply to her when she became clearly expecting.
“But I couldn’t,” she said. “I required assistance.”
The pervasive expectation that her bond with her newborn would make her recover only led to deeper self-loathing and self-harm, a trigger for her to return to drugs. Yet she could not just wish her addiction away, any more than she could will away a long-term illness.
The infant was moved to the neonatal intensive care unit. When Stephanie eventually visited her, she was connected to tubes and leads, so small she thought she would hurt her. Embracing her at last, she felt empty. “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 after her caregiver, after the attendant who showed compassion to her.
Medical personnel told her about a specialized facility, a innovative treatment home where women and their babies are treated together, not apart.
In much of the US, where a baby is found to have newborn addiction symptoms regularly, infants are still quickly moved to hospitals and given drugs while their mothers face parental assessments. But a limited but expanding group of centers like Maddie’s Place is proving a simple point: when mothers and babies stay together, outcomes improve, fewer children enter care and future expenses reduce.
It took Stephanie a period to find strength to call, but she eventually made the call. After ensuring she qualified for the program, care providers came to pick her up.
She left the medical center still in withdrawal, anxious and doubtful about what would come next.
At the facility, Stephanie still was concerned that CPS would come remove her daughter – even though she was hesitant about parenting. The fear lingered: that at any time, someone could enter 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 enduring. Substances came first; reliance came last.
Stephanie had one close friend, but even that bond was fragile. The people she loved always found ways to let her down. She lacked the ability to care for herself, let alone anyone else.
Every day, staff from the center took her to a treatment center, provided orally. Slowly, she was embracing sobriety.
She spent every minute outside treatment with Izzie, and could see that her baby was getting the specialized care she needed. Her girl had some trouble feeding at first, with intolerance to some formulas and severe digestive problems. She needed nutritional guidance. She also had increased sensitivity and required an specialist – all frequent conditions for babies affected by withdrawal.
When a child recognizes these infants need affection, then I was capable. I would become a mother.
One afternoon before Thanksgiving, Stephanie was in the common room, where those still using can come for supervised visits with their babies. An advocate, a mentor, came over with her own five kids in tow to drop off cookies. They all gathered around Stephanie, who was sitting on the floor holding Izzie.
The young ones stared in awe of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She keeps a photo of the moment. She is wearing dark trousers and a sweatshirt, a cap with a bobble on her head, seated on the ground with the exit nearby. She is lean. Her head is tilted forward so you cannot see her face. She is lifting the baby on her leg for the young ones to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the mothers: “What about the fathers?” The women attempted to clarify that the dads were busy, handling responsibilities, that they would be there given the chance.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion looked at each other. “I broke down,” Stephanie said. “When a child recognized that newborns require care, then I could do this. I could parent.”
Methods to address drug-exposed newborns have existed for decades.
The Finnegan NAS scale was created in 1975|
